Systems and methods for facilitating a first response mission at an incident scene using precision location

ABSTRACT

Systems and methods for facilitating a first response mission at an incident scene, such as an accident site, a natural or human-made disaster site, or any other first response site. One system is for locating a plurality of portable modules at an incident scene. The system comprises a plurality of receivers transportable to the incident scene. The system also comprises a processing entity configured to: determine a location of a first one of the portable modules based on first data derived from a wireless signal transmitted by the first one of the portable modules and received by at least three receivers of the plurality of receivers; and determine a location of a second one of the portable modules based on the location of the first one of the portable modules and second data derived from a wireless signal transmitted by the second one of the portable modules and received by the first one of the portable modules. For example, the system enables precision location of first responders, patients and equipment at the incident scene.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit under 35 U.S.C. §119(e) of U.S.Provisional Patent Application No. 60/992,182 filed on Dec. 4, 2007 byGraves et al. and hereby incorporated by reference herein.

FIELD OF THE INVENTION

The invention relates generally to first response services and, moreparticularly, to systems and methods for facilitating a first responsemission at an incident scene.

BACKGROUND

First responders such as emergency medical service (EMS) workers, policeofficers or firefighters deployed at an incident scene have limitedconnectivity to hospitals and other places remote from the incidentscene. In particular, first responders have limited connectivity to theemergency room (ER) of the hospital to which they are delivering and donot know the status of the ER, nor does the ER know their status. Addingto this the fact that only limited medical information, if any, can bepassed backward and forward between the first responders and thehospital, the ER treatment typically starts with a patient assessmentwhen the emergency vehicle arrives at the hospital, instead of being acontinuous process from the moment when the first responders arrive atthe incident scene.

Furthermore, the incident scene may encompass multiple casualties whohave to be triaged and stabilized on-site if their number threatens tooverwhelm the first responders. Those who are beyond hope and those whowill survive without treatment take backstage to those where treatmentmakes a difference for survival.

In addition, the incident scene itself may be hazardous, both to thecasualties and to the first responders. Unknown or undetected conditionsor changes therein at the incident scene may present serious risks forboth the casualties and the first responders.

While certain technologies have been developed to assist firstresponders, they are unsatisfactory in many respects. For example,existing technologies are typically point solutions and lack in terms ofan integrated approach which takes into account information from avariety of sources. Also, existing technologies tend to not be rapidlydeployable (i.e., seconds, not minutes or hours) and are thus often oflimited effectiveness where time is crucial. Furthermore, while it mayoften be useful to know where the first responders and/or the casualtiesare located, existing technologies may only provide inadequate orinsufficient precision in locating them (e.g., civilian grade globalpositioning system (GPS) technology typically offers accuracies of about9 to 15 meters (30 to 50 feet)., due to the user equivalent range errors(UEREs) of ionospheric effects, ephemeris errors, satellite clockerrors, multipath distortion, and tropospheric effects).

Accordingly, there is a need for solutions facilitating a first responsemission at an incident scene, and particularly for solutions providingfirst responders with bidirectional communication capability, real-timesupport for their information needs, and knowledge about theirenvironment as they stabilize and transport patients under what may behazardous conditions, solutions enabling the patients to be monitored,and solutions enabling precise location of the first responders andpatients at the incident scene.

SUMMARY OF THE INVENTION

According to a first broad aspect, the invention provides a method forlocating a plurality of portable modules at an incident scene. Themethod comprises: receiving first data derived from a wireless signaltransmitted by a first one of the portable modules and received by atleast three receivers of a plurality of receivers transported to theincident scene; determining a location of the first one of the portablemodules based on the first data; receiving second data derived from awireless signal transmitted by a second one of the portable modules andreceived by the first one of the portable modules; and determining alocation of the second one of the portable modules based on the seconddata and the location of the first one of the portable modules.

According to a second broad aspect, the invention provides a system forlocating a plurality of portable modules at an incident scene. Thesystem comprises a plurality of receivers transportable to the incidentscene. The system also comprises a processing entity configured to:determine a location of a first one of the portable modules based onfirst data derived from a wireless signal transmitted by the first oneof the portable modules and received by at least three receivers of theplurality of receivers; and determine a location of a second one of theportable modules based on the location of the first one of the portablemodules and second data derived from a wireless signal transmitted bythe second one of the portable modules and received by the first one ofthe portable modules.

According to a third broad aspect, the invention providescomputer-readable media containing computer-readable program codeexecutable by a computing apparatus to implement a process for locatinga plurality of portable modules at an incident scene. Thecomputer-readable program code comprises: first program code for causingthe computing apparatus to be attentive to receipt of first data derivedfrom a wireless signal transmitted by a first one of the portablemodules and received by at least three receivers of a plurality ofreceivers transported to the incident scene; second program code forcausing the computing apparatus to determine a location of the first oneof the portable modules based on the first data; third program code forcausing the computing apparatus to be attentive to receipt of seconddata derived from a wireless signal transmitted by a second one of theportable modules and received by the first one of the portable modules;and fourth program code for causing the computing apparatus to determinea location of the second one of the portable modules based on the seconddata and the location of the first one of the portable modules.

These and other aspects of the invention will now become apparent tothose of ordinary skill in the art upon review of the followingdescription of embodiments of the invention in conjunction with theaccompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

A detailed description of embodiments of the invention is providedbelow, by way of example only, with reference to the accompanyingdrawings, in which:

FIG. 1 shows a first response support system for facilitating a firstresponse mission at an incident scene, in accordance with an embodimentof the invention;

FIG. 2 shows a first responder pack of the first response supportsystem, in accordance with an embodiment of the invention;

FIG. 3 shows a patient pack of the first response support system, inaccordance with an embodiment of the invention;

FIG. 4 shows a drop pack of the first response support system, inaccordance with an embodiment of the invention;

FIG. 5 shows a local processing station of the first response supportsystem, in accordance with an embodiment of the invention;

FIG. 6 shows components of a healthcare facility that includes anenvironment- and context-aware system of the first response supportsystem, in accordance with an embodiment of the invention;

FIG. 7A shows services that can be provided within the healthcarefacility by the environment- and context-aware system, in accordancewith an embodiment of the invention;

FIG. 7B shows services that can be provided in support of the firstresponse mission by the environment- and context-aware system, inaccordance with an embodiment of the invention;

FIG. 8 shows at a high level an environmental awareness component and acontextual awareness and response component of the environment- andcontext-aware system, in accordance with an embodiment of the invention;

FIGS. 9A to 9E show a cascaded location process to extend alocation-awareness capability of the first response support systemacross the incident scene, in accordance with an embodiment of theinvention; and

FIGS. 10A to 10D show an example of a geometry associated with alocation determination process based on a differential time of arrivalsolution.

It is to be expressly understood that the description and drawings areonly for the purpose of illustrating certain embodiments of theinvention and are an aid for understanding. They are not intended to bea definition of the limits of the invention.

DETAILED DESCRIPTION OF EMBODIMENTS

FIG. 1 shows a first response support system 10 for facilitating a firstresponse mission at an incident scene 12 (e.g., an accident site, anatural or human-made disaster site, or any other first response site),in accordance with an embodiment of the invention. In this case, thefirst response mission involves a plurality of first responders 14 ₁ . .. 14 _(N) arriving at the incident scene 12 via a plurality of firstresponse vehicles 16 ₁ . . . 16 _(M) to perform various tasks at theincident scene 12, including providing first response aid to a pluralityof patients 18 ₁ . . . 18 _(P) at the incident scene 12, potentiallyprior to transporting some or all of them to a healthcare facility 33,which may be a hospital or other healthcare establishment. Each of thepatients 18 ₁ . . . 18 _(P) is an individual casualty at the incidentscene 12 awaiting or receiving care and treatment, such as medical careand treatment, from one or more of the first responders 14 ₁ . . . 14_(N) and/or awaiting transportation or being transported to thehealthcare facility 33 or another healthcare facility. In this example,the first responders 14 ₁ . . . 14 _(N) are emergency medical service(EMS) workers (e.g., paramedics) and the first response vehicles 16 ₁ .. . 16 _(M) are ambulances, whereas in other examples the firstresponders 14 ₁ . . . 14 _(N) may include police officers, firefightersor other types of first responders and the first response vehicles 16 ₁. . . 16 _(M) may include police vehicles, firefighter trucks or othertypes of emergency vehicles.

The first response support system 10 comprises a plurality of “packs”carried by the first responders 14 ₁ . . . 14 _(N) when arriving at theincident scene 12. Each of these packs is a portable electronic modulethat is embodied as a single portable device or combination of portabledevices carried by a given one of the first responders 14 ₁ . . . 14_(N) at the incident scene 12 (e.g., manually carried and/or worn bythat first responder). More particularly, in this embodiment, thesepacks include a plurality of first responder packs 22 ₁ . . . 22 _(N)each personally kept by a respective one of the first responders 14 ₁ .. . 14 _(N) at the incident scene 12, a plurality of patient packs 24 ₁. . . 24 _(P) each personally associated with a respective one of thepatients 18 ₁ . . . 18 _(P), and a plurality of drop packs 26 ₁ . . . 26_(R) which can be placed by the first responders 14 ₁ . . . 14 _(N) atvarious locations at the incident scene 12.

As further discussed later on, the packs 22 ₁ . . . 22 _(N), 24 ₁ . . .24 _(P), 26 ₁ . . . 26 _(R) are configured to transmit wireless signalsfrom which can be derived various data regarding the incident scene 12,such as: location data indicative of a location of each of the firstresponders 14 ₁ . . . 14 _(N), the patients 18 ₁ . . . 18 _(P) and thedrop packs 26 ₁ . . . 26 _(R) at the incident scene 12; physical dataindicative of physical parameters (e.g., surrounding temperature,pressure, vibrations, chemical concentrations, radiation levels, etc.)sensed by these packs; physiological data indicative of physiologicalparameters (e.g., vital signs such as heart rate, blood pressure, bodytemperature, oxygenation level, breathing rate; toxin levels; etc.) ofthe patients 18 ₁ . . . 18 _(P); data derived from input made by thefirst responders 14 ₁ . . . 14 _(N) using their first responder packs 22₁ . . . 22 _(N); etc.

The first responder packs 22 ₁ . . . 22 _(N) also enable the firstresponders 14 ₁ . . . 14 _(N) to wirelessly communicate with one anotherand/or with remote clinicians (e.g., physicians, radiologists,pharmacists, interns, nurses, laboratory technicians or otherindividuals whose duties relate to patient diagnosis and/or treatment)and to wirelessly receive information relevant to their tasks (e.g.,information regarding actions to be performed, such as administeringcertain medical treatment to one or more of the patients 18 ₁ . . . 18_(P), transporting one or more of the patients 18 ₁ . . . 18 _(P) to agiven healthcare facility, moving himself/herself or one or more of thepatients 18 ₁ . . . 18 _(P) to a different location, etc.).

In addition, the first response support system 10 comprises a processingsystem 20 to receive and process the wireless signals transmitted by thepacks 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) inorder to determine actions to be taken with respect to the firstresponse mission for optimizing communications involving the firstresponders 14 ₁ . . . 14 _(N) and increasing first respondereffectiveness, quality of care to patients, patient/first respondersafety, speed of processing and overall first response site safety.Examples of such actions include: administration of certain medicaltreatment to one or more of the patients 18 ₁ . . . 18 _(P); movement ofone or more of the patients 18 ₁ . . . 18 _(P) and/or the firstresponders 14 ₁ . . . 14 _(N); communication of one or more of the firstresponders 14 ₁ . . . 14 _(N) with one or more doctors, nurses or otherclinicians remote from the incident scene 12; transportation of one ormore of the patients 18 ₁ . . . 18 _(P) to one or more healthcarefacilities (e.g., transportation of different ones of the patients 18 ₁. . . 18 _(P) to different healthcare facilities for load sharingbetween the different healthcare facilities); preparation of resources(e.g., equipment and clinicians) at one or more healthcare facilitiesfor arrival of one or more of the patients 18 ₁ . . . 18 _(P); etc.

More particularly, in this embodiment, the processing system 20comprises a remote processing subsystem 30 located remotely from theincident scene 12 and a plurality of local processing stations 28 ₁ . .. 28 _(M) transported to the incident scene 12 by respective ones of thefirst response vehicles 16 ₁ . . . 16 _(M). In this example, the remoteprocessing subsystem 30 is located at a healthcare facility 33, whichmay be a hospital or other healthcare establishment. Each of the localprocessing stations 28 ₁ . . . 28 _(M) can communicate with the remoteprocessing subsystem 30 via a wireless communication link 32, which maybe established over an emergency services network and/or acommunications provider network (e.g., a cellular, WiMax or other publicor dedicated emergency services wireless network).

As further described later, in this embodiment, the remote processingsubsystem 30 implements, and will hereinafter be referred to as, an“environment- and context-aware system” (ECAS) configured to determinewhich actions should be taken with respect to the first response missionwhen certain “situations” are deemed to occur, based on data derivedfrom wireless signals transmitted by the packs 22 ₁ . . . 22 _(N), 24 ₁. . . 24 _(P), 26 ₁ . . . 26 _(R) at the incident scene 12. The ECAS 30can be viewed as a smart (e.g., artificially intelligent) communicationand information handling system which operates to achieve specificobjectives set by applicable policies or guidelines/targets that itinvokes on a basis of its deducing situations deemed to occur from itsenvironmental and other contextual information sources and deductions.In regards to the first response mission considered in this example, thepolicies or guidelines/targets address optimization of communicationsinvolving the first responders 14 ₁ . . . 14 _(N) and increasing firstresponder effectiveness, quality of care to patients, patient/firstresponder safety, speed of processing and overall first response sitesafety.

For their part, the local processing stations 28 ₁ . . . 28 _(M) aretransported to the incident scene 12 by respective ones of the firstresponse vehicles 16 ₁ . . . 16 _(M) and provide communication, dataprocessing and other functionality between the packs 22 ₁ . . . 22 _(N),24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS 30 (and otherresources within the healthcare facility 33). In that sense, the localprocessing stations 28 ₁ . . . 28 _(M) will be referred to as “ECASoutstations”.

Generally speaking, the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26₁ . . . 26 _(R), the ECAS outstations 28 ₁ . . . 28 _(M) and the ECAS 30can cooperate to provide information, communication and protective(against hazardous conditions) support to the first responder vehicles16 ₁ . . . 16 _(M), the first responders 14 ₁ . . . 14 _(N) and thepatients 18 ₁ . . . 18 _(P) at the incident scene 12 during first triageand treatment, stabilization and preparation for transport to bring thepatients 18 ₁ . . . 18 _(P) into a clinical treatment system which, inthis example, is centered at the healthcare facility 33 (and possiblyone or more other healthcare facilities as may be involved).

The ECAS outstations 28 ₁ . . . 28 _(M) transported to the incidentscene 12 and the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . .. 26 _(R) deployed by the first responders 14 ₁ . . . 14 _(N) at theincident scene 12 enable capabilities of the ECAS 30 to be extended intoa first response area at the incident scene 12. For example, some of thecapabilities of the ECAS 30 that may be extended into the first responsearea include:

-   -   i. Precision location (absolute location or relative        location/proximity) for the first response vehicles 16 ₁ . . .        16 _(M), the first responders 14 ₁ . . . 14 _(N) and the        patients 18 ₁ . . . 18 _(P) at the incident scene 12;    -   ii. Automated monitoring of environmental conditions across the        incident scene 12 for purposes of detecting inclement, adverse        or potentially hazardous situations;    -   iii. An ability for the first responders 14 ₁ . . . 14 _(N) to        be clinically integrated into workflows and resources of the        healthcare facility 33, particularly its emergency room (ER),        during the stabilization and preparation for transport of the        patients 18 ₁ . . . 18 _(P) so that the healthcare facility's        staff and clinical resources and databases to which the ECAS 30        has access can provide support as needed to the first responders        14 ₁ . . . 14 _(N) and so that the healthcare facility 33 can be        provided with advance information on conditions of incoming ones        of the patients 18 ₁ . . . 18 _(P);    -   iv. An ability for the ECAS 30 and/or remote clinicians to        remotely track the locations of the patients 18 ₁ . . . 18 _(P)        and monitor the patients 18 ₁ . . . 18 _(P) (including        unattended ones) for key medical data and life sign        characteristics; and    -   v. Automatic association of the first responders 14 ₁ . . . 14        _(N) with different ones of the patients 18 ₁ . . . 18 _(P) that        they are treating or responsible for.

These and other capabilities of the ECAS 30 which can be extended intothe first response area at the incident scene 12 can enhance theeffectiveness, productivity and/or safety of the first responders 14 ₁ .. . 14 _(N) and the quality of care, speed of response and care, and/orsafety of the patients 18 ₁ . . . 18 _(P).

The aforementioned components of the first response support system 10will now be discussed in more detail.

Packs 22 ₁ . . . 24 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R)

The packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R)communicate with the ECAS outstations 28 ₁ . . . 28 _(M) and the ECAS 30of the processing system 20 to perform various functions, including:providing an accurate precision location capability across the incidentscene 12, which allows the first responders 14 ₁ . . . 14 _(N) and thepatients 18 ₁ . . . 18 _(P) to be tracked and associations to beestablished therebetween; providing location-aware sensor informationabout environmental conditions at the incident scene 12, which allowshazardous or adverse conditions to be detected; and facilitatingcommunications, including communication between the first responders 14₁ . . . 14 _(N) and remote clinicians at the healthcare facility 33 aswell as access to clinical information (which may be suitably profiledfor first response use) from an institutional information system of thehealthcare facility 33.

a) First Responder Packs 22 ₁ . . . 22 _(N)

FIG. 2 shows an embodiment of a first responder pack 22 _(j) of thefirst responder packs 22 ₁ . . . 22 _(N) that is kept by a firstresponder 14 _(j) of the first responders 14 ₁ . . . 14 _(N) at theincident scene 12. Other ones of the first responder packs 22 ₁ . . . 22_(N) may be similarly constructed.

The first responder pack 22 _(j) comprises suitable hardware andsoftware (which may include firmware) for implementing a plurality offunctional components, including, in this embodiment, a location unit40, an identification unit 46, a sensor unit 48, a wireless interface42, a user interface 52, a communication unit 59, a processing entity 50and a power supply 44. These functional components may be embodied as asingle portable device or combination of portable devices carried by thefirst responder 14 _(j). For example, the single portable device orcombination of portable devices constituting the first responder pack 22_(j) may be manually carried by the first responder 14 _(j) and/or wornby the first responder 14 _(j) (e.g., strapped or otherwise attached onthe first responder 14 _(j) or integrated with his/her clothing). Thefirst responder pack 22 _(j) may be assigned to or associated with thefirst responder 14 _(j) before or upon arrival at the incident scene 12by various means (e.g., by entering an identity of the first responder14 _(j) and/or a password confirming this identity and/or by biometricassociation).

The location unit 40 enables the processing system 20 to determine alocation of the first responder 14 _(j). To that end, the location unit40 comprises a location transmitter (e.g., a location pinger) 41 totransmit a wireless location signal that allows the processing system 20to determine the location of the first responder pack 22 _(j) and, thus,of the first responder 14 _(j). For example, the wireless locationsignal may be a short (e.g., nanosecond scale) radio frequency (RF)burst or series of short RF bursts. The processing system 20 candetermine the location of the first responder 14 _(j) based on dataderived from the wireless location signal, i.e., data conveyed by thatsignal and/or data generated upon reception of that signal such as datarelated to a time of arrival of that signal at a receiver having a knownlocation. More particularly, in this embodiment, the processing system20 determines the location of the first responder 14 _(j) based on threeor more times of arrival of the wireless location signal at three ormore location receivers (described later on) having known locations thatare distributed among some of the ECAS outstations 28 ₁ . . . 28 _(M)and/or other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R),24 ₁ . . . 24 _(P). For instance, the processing system 20 may applytriangulation techniques (e.g., multilateration or trilateration) todetermine the location of the first responder 14 _(j) based on the timesof arrival of the wireless location signal at these three of morelocation receivers. Such triangulation techniques, which can be based ontimes of arrival either explicitly (i.e., on the times of arrivalthemselves) or implicitly (i.e., on differences between the times ofarrival), are well known and need not be described here. In otherembodiments, rather than allow the processing system 20 to effectlocation computations based on times of arrival of the wireless locationsignal transmitted by the location transmitter 41, the wireless locationsignal may convey other location data that indicates or can be used tocompute the location of the first responder 14 _(j).

In addition, in this embodiment, once the first responder pack 22 _(j)has been located, the location unit 40 enables the processing system 20to determine locations of other ones of the packs 22 ₁ . . . 22 _(N), 26₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the firstresponder pack 22 _(j). To that end, the location unit 40 comprises alocation receiver (e.g., a location sensor) 43 to receive wirelesslocation signals from location transmitters of other ones of the packs22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that arewithin range of the first responder pack 22 _(j). As further discussedlater on, once it has been located by the processing system 20, thefirst responder pack 22 _(j) may transmit a wireless signal to theprocessing system 20 on a basis of the wireless locations signals itreceives from these location transmitters in order to allow theprocessing system 20 to determine locations of those packs 22 ₁ . . . 22_(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) from which the firstresponder pack 22 _(j) received the wireless location signals.

Generally speaking, in this embodiment, and in accordance with a“cascaded location process” that is further discussed later on, thelocations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . .. 24 _(P) are determined in multiple stages by the processing system 20,whereby those packs whose locations are known are used to receivewireless location signals from other packs whose locations are unknownand transmit wireless signals to the processing system 20 on a basis ofthe wireless location signals that they receive in order to enable thelocations of these other packs to be determined. This is particularlyuseful in that it allows the first response support system 10 to extendits location-awareness across the incident scene 12 by using packs whichhave been located in order to locate further packs that may be beyondthe range of location receivers of the ECAS outstations 28 ₁ . . . 28_(M).

In order for the cascaded location process to precisely locate the packs22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), errorpropagation through the stages of the process should be minimized. Tothat end, the location unit 40 of each of the first responder packs 22 ₁. . . 22 _(N), similar location units of the drop packs 26 ₁ . . . 26_(R) and the patient packs 24 ₁ . . . 24 _(P) (described later on), andsimilar location units of the ECAS outstations 28 ₁ . . . 28 _(M) (alsodescribed later on), may employ wireless technology allowing a locationof each of these components to be determined with an excessive level ofprecision, such as 1 m or better (e.g., 50 cm or even less), to permit abuild-up of tolerances in a concatenated location approach to maintainan adequate final level of accuracy (e.g., this may be on the order of 1m, for instance, to locate people, but may be much more precise, in somecases less than 30 cm, to allow automated associations between people orbetween people and equipment). For example, in this embodiment, thelocation units may employ ultra-wideband (UWB) technology (e.g., UWBtags) which offers increased precision, down to tens of centimeters orless (e.g., dependent upon “burst” envelope rise and fall times andreceiver clock accuracy). In addition to permitting an expanded range ofapplications, such as associating a pack with a person near it, or twopeople together such as one of the first responders 14 ₁ . . . 14 _(N)and one of the patients 18 ₁ . . . 18 _(P), the increased precision ofUWB technology helps to minimize error propagation through the stages ofthe cascaded location process (where positional errors can be cumulativein a complex but deterministic manner).

The identification unit 46 provides identification data serving toidentify the first responder pack 22 _(j). The identification data maycomprise one or more identifiers, such as an alphanumeric code (e.g., aUWB tag code, a serial number associated with the first responder pack22 _(j), etc.). The wireless location signal transmitted by the locationunit 40 of the first responder pack 22 _(j) may comprise theidentification data (or data derived therefrom) to allow the processingsystem 20 to identify the first responder pack 22 _(j) it is locating.In this respect, while they are shown as separate components, it will berecognized that in some embodiments functionality of the identificationunit 46 and the location unit 40 (and particularly its locationtransmitter 41) may be implemented by a common component (e.g., a UWBtag).

In some embodiments, the identification unit 46 may also provide dataidentifying the first responder 14 _(j) to allow the processing system20 to identify the first responder 14 _(j) associated with the firstresponder pack 22 _(j). For example, the identification unit 46 maystore an identifier such as name of the first responder 14 _(j). Theidentifier, which may be provided in the identification unit 46 invarious ways such as by coding at issue to the first responder 14 _(j)or by a process of identification and authentication while in transit toor at arrival at to the incident scene 12 (e.g., a fingerprint scan orentry of the identifier and possibly a password using the user interface52), can be used to identify the first responder 14 _(j) to the ECAS 30both for first responder/patient association and for ECAS-enabled accessto clinical services and communications (e.g., allowing remoteclinicians at the healthcare facility 33 to know which first responder,which patient—by proximity—and any collected data so they can providebetter support). In cases where the identification unit 46 does notprovide data explicitly identifying the first responder 14 _(j), theprocessing system 20 may already store an association between theidentification data provided by the identification unit 46 and anidentity of the first responder 14 _(j) (e.g., further to a provisioningphase where the first responder pack 22 _(j) was assigned to the firstresponder 14 _(j)).

The sensor unit 48 enables the processing system 20 to understandphysical conditions of the incident scene 12 around the first responder14 _(j). This allows detection of various inclement, adverse orhazardous conditions which the first responder 14 _(j) (and possibly oneor more patients he/she may be handling) may face and alerting the firstresponder 14 _(j) when such conditions are detected (e.g., notifying thefirst responder 14 _(j) to evacuate its current location, eitherdirectly when a predetermined threshold is exceeded or in response to amessage received from the ECAS 30), thereby improving his/her safety(and that of the one or more patients he/she may be handling).

More particularly, the sensor unit 48 comprises one or more physicalsensors for sensing one or more physical parameters (e.g., temperature,pressure, chemical concentration, electromagnetic radiation level suchas light intensity or hard radiation level, vibration level, etc.)and/or other physical activity (e.g., motion of a person or object)around the first responder pack 22 _(j) and for generating physical dataindicative of these one or more physical parameters and/or otherphysical activity. For example, the sensor unit 48 may comprise one ormore of: temperature/heat sensors (e.g., to detect surroundingtemperature); pressure sensors (e.g., to detect atmospheric pressure);chemical sensors (e.g., to sense concentrations or traces of chemicals,such as explosive substances); mass/weight sensors (e.g., to sensemass/weight of persons or objects); vibration sensors (e.g., to senseground vibrations); movement sensors (e.g., to sense movement of personsor objects); sound sensors (e.g., to sense voices, mechanical sounds,sounds from movement); visible light sensors (e.g., to sense visiblelight intensity); infrared light sensors (e.g., to sense infrared lightemitted by persons or objects or effect video surveillance); RF sensors(e.g., to sense RF emissions or interference); hard radiation sensors(e.g., to sense x-rays, gamma rays or other hard radiation to effectGeiger counter/detection of nuclear decay, hidden object sensing);biotoxin sensors (e.g., to sense airborne or surface toxins, bacteria orviruses); cameras (e.g., to detect movement or identify person orobjects, for instance, to effect video surveillance or provide imageryof a nearby patient to remote clinicians at the healthcare facility 33);liquid sensors (e.g., to sense presence of water or other liquids); andgas/vapor sensors (e.g., to sense presence of hazardous or harmful gasessuch as H₂S, CO, methane or propane, and/or hazardous or harmful vaporsor gases such as chlorine, fluorine, bromine or petroleum vapors; tosense inadequate levels of oxygen, or presence of smoke or combustionproducts; etc). These examples are presented for illustrative purposesonly as the sensor unit 48 may comprise sensors with various othersensing capabilities.

In addition to its location and sensing functions, the first responderpack 22 _(j) can serve as a remote field-located communications terminallinked to the ECAS 30 and other resources of the healthcare facility 33,enabling the first responder 14 _(j) to be treated as a clinician with aspecific set of services and access rights, as appropriate to firstresponders and adapted by the ECAS 30 understanding the firstresponder's context.

More specifically, the user interface 52 enables the first responder 14_(j) to exchange information with the ECAS 30. It comprises a displayand possibly one or more other output elements (e.g., a speaker, etc.)enabling the first responder pack 22 _(j) to present information to thefirst responder 14 _(j), as well as one or more input elements (e.g., akeyboard, a microphone, a pointing device, a touch sensitive surface, astylus perhaps built into a glove finger, etc.) enabling the firstresponder 14 _(j) to input information into the first responder pack 22_(j). These input and output elements of the user interface 52 may beadapted for rough and hostile outside conditions and/or various levelsof illumination from direct sunlight to near-darkness in which the firstresponder 14 _(j) may evolve at the incident scene 12, and be able to beoperated by the first responder 14 _(j) when in appropriate protectiveclothing (e.g., a heavy coat and gloves in winter conditions).

Various exchanges of information may take place between the firstresponder 14 _(j) and the ECAS 30 using the user interface 52. Forexample, the first responder 14 _(j) may: pull up any availableinformation from an electronic healthcare record, such as an electronichealth record (EHR), electronic patient record (EPR) or electronicmedical record (EMR), of a patient he/she is treating should it existand should the patient have been identified; open up and populate amedical data file with information about the patient, such as personalinformation, his/her condition and/or what has been done to the him/herby the first responder 14 _(j), by a semi-automated process (which mayinvolve the patient's patient back as discussed below), the medical datafile being integrated into the patient's EHR, EPR or EMR if it can becross-referenced thereto or being delivered as a stand-alone record; usedecision information support tools (DIST) or other applicationsimplemented by the ECAS 30; and/or receive information regarding actionsto be performed, such as administering certain medical treatment to oneor more of the patients 18 ₁ . . . 18 _(P), transporting one or more ofthe patients 18 ₁ . . . 18 _(P) to a given healthcare facility, movinghimself/herself or one or more of the patients 18 ₁ . . . 18 _(P) to adifferent location, etc, based on determinations made by the ECAS 30. Inthis respect, the first responder pack 22 _(j) may interact with theECAS 30 to identify and authenticate the first responder 14 _(j) and toprovide him/her with a broad range of services and capabilities basedupon his/her authorization profile, but adapted by the ECAS's computedcurrent situational and institutional context surrounding the firstresponder 14 _(j).

The communication unit 59 is configured to enable the first responder 14_(j) to wirelessly communicate with other parties, such as other ones ofthe first responders 14 ₁ . . . 14 _(N), individuals remote from theincident scene 12 such as doctors or other clinicians at the healthcarefacility, and/or automated speech, text and/or image processing systems.In particular, the communication unit 59 enables the first responder 14_(j) to communicate with clinicians at the healthcare facility 33,especially those in its receiving ER, both to allow these clinicians toassist in stabilizing a patient treated by the first responder 14 _(j)and to allow these clinicians to better prepare to receive that patient.To achieve its function, the communication unit 59 comprises amicrophone and possibly other input elements (e.g., a keypad, touchsensitive surface) as well as a speaker and possibly other outputelements (e.g., a display) to allow the first responder 14 _(j) tocommunicate. The communication unit 59 also comprises a transmitter anda receiver to send and receive wireless signals establishingcommunications involving the first responder 14 _(j). In someembodiments, the communication unit 59 may be integrated with one ormore other devices of the first responder pack 22 _(j), in particular,it may be implemented by the processing entity 50, the wirelessinterface 42 and the user interface 52. In other embodiments, thecommunication unit 59 may be implemented as a communication device(e.g., a mobile phone, including a wireless-enabled personal digitalassistant (PDA)) which may be separate from the user interface 52 andthe wireless interface 42 of the first responder pack 22 _(j) and whichmay linked to an emergency wireless network or a service providerwireless network.

The wireless interface 42 provides a bidirectional communicationcapability to connect the first responder pack 22 _(j) to the ECASoutstations 28 ₁ . . . 28 _(M) (e.g., to report location and sensorinformation) and, in embodiments where it is used to implement thecommunication unit 59, to provide a bidirectional communication channelfor the first responder 14 _(j). More particularly, the wirelessinterface 42 comprises a wireless transmitter to transmit wirelesssignals destined for one or more of the ECAS outstations 28 ₁ . . . 28_(M) and conveying data generated by the first responder pack 22 _(j),such as data derived from a wireless location signal received by itslocation receiver 43 (e.g., data related to a time of arrival of thatsignal), data generated by its sensor unit 48 and/or data derived frominput made by the first responder 14 _(j) via the user interface 52.Also, the wireless interface 42 comprises a wireless receiver to receivewireless signals from one or more of the ECAS outstations 28 ₁ . . . 28_(M) and conveying data destined for the first responder pack 22 _(j),such as data representing information to be presented to the firstresponder 14 _(j) via the user interface 52 (e.g., information regardingactions to be performed, such as administering certain medical treatmentto one or more of the patients 18 ₁ . . . 18 _(P), transporting one ormore of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility,moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P)to a different location, etc.) and/or data indicative of commands to beexecuted by the first responder pack 22 _(j) (e.g., commands toactivate/deactivate the location receiver 43 and/or one or more sensorsof the sensor unit 48).

The processing entity 50 performs various processing operations toimplement functionality of the first responder pack 22 _(j). Forexample, these processing operations may include operations to: processdata generated by the sensor unit 48, data derived from a wirelesslocation signal received by the location receiver 43 (e.g., data relatedto a time of arrival of that signal), and data derived from input madeby the first responder 14 _(j) via the user interface 52;activate/deactivate components of the first responder pack 22 _(j)(e.g., the location receiver 43 and/or one or more sensors of the sensorunit 48); cause the wireless interface 42 to transmit a wireless signalconveying data derived from a wireless location signal received by thelocation receiver 43 (e.g., data related to a time of arrival of thatsignal), data generated by the sensor unit 48 and/or data derived frominput made by the first responder 14 _(j) via the user interface 52;cause the user interface 52 to present (e.g., display) to the firstresponder 14 _(j) information derived from a wireless signal receivedvia the wireless interface 42; etc.

The processing operations may also implement a timing andsynchronization function to ensure that the location transmitter 41transmits wireless location signals at precise instants and that timesof arrival of wireless locations signals at the location receiver 43 areaccurately measured. This measurement may be made based on an absolutetiming reference that can be distributed amongst the packs 22 ₁ . . . 22_(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECAS outstations 28₁ . . . 28 _(M). Alternatively, the measurement may be made relative toa local timing of the location transmitter 41, in which case a“relative” time of reception at the location receiver 43 of a wirelesslocation signal transmitted by an unlocated one of the packs 22 ₁ . . .22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) can be captured andforwarded to the processing system 20. Since it knows the times ofreception of wireless location signals transmitted by the locationtransmitter 41 and has computed the location of that transmitter, theprocessing system 20 can compute the distance to and hence time offlight from the location receiver 43 and thus can determine, from themeasured and reported relative time, the actual time of arrival at thelocation receiver 43 of the wireless location signal transmitted by theunlocated pack. (For example, considering a case in which the pack 14 22_(j) is 114 ft away from the ECAS outstation 28 _(k) and receives awireless location signal from a further away unlocated pack, say pack X,at 85 ns before its own wireless location signal is transmitted andpasses this data on to the ECAS outstation 28 _(k), the ECAS outstation28 _(k) may look at the timing of the located pack's signals (say anarbitrary 405 ns reference its own time datum) and subtract the time offlight of 114 ns from that to determine that the pack 22 _(j)transmitted at 291 ns and subtract 85 ns from that to determine that theunlocated pack's signal was received at the located pack 22 _(j) at 206ns. If this is compared with the results from two other located packs,say packs B and C, for instance, yielding results of 222 ns and 175 nsthen the differential differences are pack B—pack 22 _(j)=222−206=16 ns,pack B—pack C=222−175=47 ns and pack 22 _(j)—pack C=206−175=31 ns,placing the unlocated pack X at 16 ft further from pack B than pack 22_(j), 47 ft further from pack B than pack C and 31 ft further from packC than pack B. Knowing the locations of the packs 22 _(j), B, C, theprocessing system 20 can “draw” the lines of location which meet thecriterion of being 16 ft further from pack B than the pack 22 _(j),another set of lines of location which meet the criterion of being 47 ftfurther from pack B than pack C and yet another set of lines which meetthe criterion of being 31 ft further from pack A than pack C. Theselines intersect at only one point, which corresponds to the location ofthe unlocated pack.)

The processing entity 50 comprises one or more processors to perform itsvarious processing operations. A given one of these one or moreprocessors may be a general-purpose processor having access to a storagemedium (e.g., semiconductor memory, including one or more ROM and/or RAMmemory devices) storing program code for execution by that processor toimplement the relevant processing operations. Alternatively, a given oneof these one or more processors may be a specific-purpose processorcomprising one or more pre-programmed hardware or firmware elements(e.g., application-specific integrated circuits (ASICs), electricallyerasable programmable read-only memories (EEPROMs), etc.) or otherrelated elements to implement the relevant processing operations.

The power supply 44 comprises one or more batteries and/or other powerstorage elements to supply power to the various components of the firstresponder pack 22 _(j). The power supply 44 has a power capacityenabling the first responder pack 22 _(j) to be used as long as possiblefor purposes of the first response mission at the incident scene 12(e.g., about sixteen hours to handle cases where the first responder 14_(j) works a double shift). The power supply 44 may also have chargingcircuitry to facilitate its recharging. The power supply 44 may alsoprovide power by other means. For example, it may comprise poweringelements to provide power based on solar or vibrational energy, whichcan be used to supplement its primary energy source.

While in this embodiment the first responder pack 22 _(j) comprisesvarious components, in other embodiments, it may not comprise all ofthese components and/or may comprise different components.

b) Patient Packs 24 ₁ . . . 24 _(P)

FIG. 3 shows an embodiment of a patient pack 24 _(j) of the patientpacks 24 ₁ . . . 24 _(P) that is personally associated with a patient 18_(j) of the patients 18 ₁ . . . 18 _(P) at the incident scene 12. Otherones of the patient packs 24 ₁ . . . 24 _(P) may be similarlyconstructed.

The patient pack 24 _(j) comprises suitable hardware and software (whichmay include firmware) for implementing a plurality of functionalcomponents, including, in this embodiment, a location unit 140, anidentification unit 146, a sensor unit 148, a wireless interface 142, aprocessing entity 150 and a power supply 144. These functionalcomponents may be embodied as a single portable device or combination ofportable devices carried by a first responder 14 _(k) of the firstresponders 14 ₁ . . . 14 _(N) at the incident scene 12 until he/shereaches the patient 18 _(j) and associates the single portable device orcombination of portable devices with the patient 18 _(j). For example,the single portable device or combination of portable devicesconstituting the patient pack 18 _(j) may be strapped or otherwise fixedto the patient 18 _(j) and/or may be placed adjacent to the patient 18_(j) (e.g., in cases where the patient 18 _(j) is expected to remainimmobile, for instance, due to injury) by the first responder 14 _(k).

The location unit 140 enables the processing system 20 to determine alocation of the patient 18 _(j). To that end, the location unit 140comprises a location transmitter (e.g., pinger) 141 to transmit awireless location signal that allows the processing system 20 todetermine the location of the patient pack 24 _(j) and, thus, of thepatient 18 _(j). For example, the wireless location signal may be ashort RF burst or series of short RF bursts. More particularly, in thisembodiment, the processing system 20 determines the location of thepatient 18 _(j) based on three or more times of arrival of the wirelesslocation signal at three of more location receivers having knownlocations that are distributed among some of the ECAS outstations 28 ₁ .. . 28 _(M) and/or other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . .. 26 _(R), 24 ₁ . . . 24 _(P) using triangulation techniques. In otherembodiments, rather than allow the processing system 20 to effectlocation computations based on times of arrival of the wireless locationsignal transmitted by the location transmitter 141, the wirelesslocation signal may convey other location data that indicates or can beused to compute the location of the patient 18 _(j).

In addition, in this embodiment, once the patient pack 24 _(j) has beenlocated, the location unit 140 enables the processing system 20 todetermine locations of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁. . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the patientpack 24 _(j). To that end, the location unit 140 comprises a locationreceiver (e.g., a location sensor) 143 to receive wireless locationsignals from location transmitters of other ones of the packs 22 ₁ . . .22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range ofthe patient pack 24 _(j). As part of the aforementioned cascadedlocation process (which is further discussed later on), once it has beenlocated by the processing system 20, the patient pack 24 _(j) maytransmit a wireless signal to the processing system 20 on a basis of thewireless location signals it receives from these location transmittersin order to allow the processing system 20 to determine locations ofthose packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)from which it received the wireless location signals. As mentionedabove, in order to minimize error propagation through the stages of thecascaded location process, the location unit 140 may employ wirelesstechnology allowing a location of those packs within its range to bedetermined with an excessive level of precision, such as 1 m or better(e.g., 50 cm or even less), to permit a build-up of tolerances in aconcatenated location approach to maintain an adequate final level ofaccuracy. For example, in this embodiment, the location unit 140 mayemploy UWB technology (e.g., a UWB tag) which offers increased accuracy,down to tens of centimeters or less.

The identification unit 146 provides identification data serving toidentify the patient pack 24 _(j). The identification data may compriseone or more identifiers, such as an alphanumeric code (e.g., a UWB tagcode, a serial number associated with the patient pack 24 _(j), etc.).The wireless location signal transmitted by the location unit 140 of thepatient pack 24 _(j) may comprise the identification data (or dataderived therefrom) to allow the processing system 20 to identify thepatient pack 24 _(j) it is locating. In this respect, while they areshown as separate components, it will be recognized that in someembodiments functionality of the identification unit 146 and thelocation unit 140 (and particularly its location transmitter 141) may beimplemented by a common component (e.g., a UWB tag).

In some embodiments, the identification unit 146 may also store dataidentifying the patient 18 _(j) and/or data indicative of his/her status(e.g., his/her condition and/or priority/treatment) to allow theprocessing system 20 to identify the patient 18 _(j) associated with thepatient pack 24 _(j) and/or know his/her status. For example, theidentification unit 146 may store a name and/or healthcare cardregistration number of the patient 18 _(j) and/or a triage code (e.g., atriage color code) assigned to the patient 18 _(j). This information mayinitially be input into the identification unit 146 by the firstresponder 14 _(k) who associates the patient pack 24 _(j) with thepatient 18 _(j). For example, in some cases, the patient pack 24 _(j)may comprise a user interface (not shown) comprising a display andpossibly one or more other output elements (e.g., a speaker, etc.) andone or more input elements (e.g., a keyboard, a microphone, a pointingdevice, a touch sensitive surface, a stylus, etc.) to enable the firstresponder 14 _(k) to enter the patient's name (and/or other identifier)and/or the triage code into the identification unit 146. As analternative, the first responder 14 _(k) may activate a predeterminedidentifier for the patient pack 24 _(j), which becomes the identifierassociated with data regarding the patient 18 _(j) (e.g., patientclinical and non-clinical data) until a patient identity is made/added,either at activation or at a subsequent time. In other cases, the firstresponder 14 _(k) may use the user interface 52 of his/her firstresponder pack 22 _(k) to enter the patient's name and/or the triagecode into the identification unit 146 of the patient pack 24 _(j). Forinstance, each of the first responder pack 22 _(k) and the patient pack24 _(j) may comprise a short-range data exchange interface (e.g., aninfrared data exchange interface) via which the patient's name and/orthe triage code entered into the first responder pack 22 _(k) by thefirst responder 14 _(k) may be transferred to the identification unit146 of the patient pack 24 _(j). Alternatively, upon establishment of aproximate state between the patient pack 24 _(j) and first responderpack 22 _(k), the processing system 20 may create an association betweenthe first responder 14 _(k) and the patient 18 _(j) and, as soon as thefirst responder 14 _(k) captures an identity for the patient (e.g. “Mr.John Smith III of 17 Crestview Drive, Richmond”, patient with healthcard registration # 023-6043-507321, or just unknown casualty #17) usinghis/her first responder pack 22 _(k), this identity is added to theassociation and from there is downloaded into the patient pack 24 _(j)via a given one of the ECAS outstation 28 ₁ . . . 28 _(M) and thewireless interface 142.

Alternatively or additionally, in some embodiments, the first responder14 _(k) may place an ID bracelet on the patient 18 _(j) and use this IDbracelet to provide information identifying the patient 18 _(j) to theprocessing system 20. The ID bracelet may have a readable identifier(e.g., a barcode, an alphanumeric code, etc.) which the first responder14 _(k) may associate with the identification data stored in theidentification unit 146 of the patient pack 24 _(j) in order to allowthe processing system 20 to identify the patient 18 _(j) associated withthe patient pack 24 _(j).

For example, in one embodiment, the readable identifier of the IDbracelet may be a machine-readable identifier (e.g., a barcode), thepatient pack 24 _(j) may be provided with a machine-readable identifierconveying part or all of the identification data stored in theidentification unit 146 (e.g., a UWB tag code), and the first responderpack 22 _(k) may comprise a suitable reader (e.g., a barcode reader) toread each of these two identifiers. Upon using this reader to read thetwo identifiers, the first responder 14 _(k) may use the user interface52 of the first responder pack 22 _(k) to enter the patient's name andtriage code and/or other status data. In order to expedite this dataentry process, the processing entity 50 of the first responder pack 22_(k) may implement a data entry application including a database ofcommon first and last names and/or a list of triage codes and/or othercodes indicative of frequent medical condition or necessities (e.g.,“immobilize patient before transportation”, for instance, in case of asevere neck injury), whereby the first responder 14 _(k) can rapidlyenter the patient's name by entering starting letters and selecting froma list of candidate names from the database and/or can quickly select adesired triage code or other relevant code from the list of codes. Oncethis information is entered, the first responder pack 22 _(k) maytransmit a wireless signal conveying the identifier read from the IDbracelet and the identifier read from the patient pack 24 _(j), as wellas the patient's name and/or the triage or other code, to the processingsystem 20 via its wireless interface 42 in order to allow the processingsystem 20 to identify the patient 18 _(j) associated with the patientpack 24 _(j) and know his/her status.

As another example, in one embodiment, the readable identifier of the IDbracelet may be a human-readable identifier (e.g., an alphanumeric code)and the patient pack 24 _(j) may be provided with a human-readableidentifier conveying part or all of the identification data stored inthe identification unit 146 (e.g., a UWB tag code or a code associatedtherewith in the processing system 20). In this case, the firstresponder 14 _(k) may use the user interface 52 of his/her firstresponder pack 22 _(k) to enter each of these two identifiers as well asthe patient's name and triage code or other status data, and, once thisinformation is entered, the first responder pack 22 _(k) may transmit awireless signal conveying this information to the processing system 20via its wireless interface 42 in order to allow the processing system 20to identify the patient 18 _(j) associated with the patient pack 24_(j).

In other examples, the processing system 20 may identify the patient 18_(j) associated with the patient pack 24 _(j) in various other ways,based on an association between the readable identifier of the IDbracelet and the identification data stored in the identification unit24 of the patient pack 24 _(j). Also, in other examples, other types ofwearable identification elements (e.g., badges, stickers, etc.) having areadable identifier may be placed on the patient 18 _(j) instead of anID bracelet.

In view of the foregoing, when the first responder 14 _(k) associatesthe patient pack 24 _(j) with the patient 18 _(j), the processing system20 detects proximity of the first responder 14 _(k) to the patient 18_(j) and, based on this proximity, proceeds to create an associationbetween the first responder 14 _(k) and the patient 18 _(j). In caseswhere the first responder 14 _(k) ascertained the identity of thepatient 18 _(j), the first responder 14 _(k) may be able to access anypre-existing EHR, EMR or EPR information for the patient 18 _(j),suitably filtered for first response use, using his/her first responderpack 22 _(k) and the healthcare facility 33 may be able to betterprepare for receiving the patient 18 _(j) since it can both track thepatient's context, status and progress as he/she is handled coming outof the incident scene en route to its ER. The first responder 14 _(k)and/or remote clinicians at the healthcare facility 33 can thus be madeaware (from the patient EHR as well as field data) of pre-existingspecial circumstances surrounding the patient 18 _(j). For example, ifthe patient 18 _(j) is comatose from his/her injuries and may also bediabetic, his/her blood sugar may be monitored closely. As anotherexample, if the patient 18 _(j) is known to have a pre-existing heartcondition and has a crushed left leg resulting from events at theincident scene 12, he/she has an increased chance of dying due tostress-induced heart failure and so must be treated differently than ahealthy person with the same injury. In cases where the patient 18 _(j)cannot readily be medically identified and associated with medicalrecords, he/she may still be allocated a unique but arbitrary identifierto track their progress and treatment until they arrive at thehealthcare facility 33.

The sensor unit 148 enables the processing system 20 to understandphysical conditions of the incident scene 12 around the patient 14 _(j),allowing detection of various inclement, adverse or hazardous conditionssurrounding the patient 14 _(j), thereby improving his/her safety. Inaddition, the sensor unit 148 enables monitoring of a medical conditionof the patient 14 _(j) that is reported to the ECAS 30. This allows theECAS 30 to continuously monitor the patient 14 _(j) at the incidentscene 12, even if no first responder can be with him/her (e.g., in caseswhere there are more casualties than first responders). This can alsoallow the ECAS 30, which may have access to EHR, EMR or EPR informationof the patient 14 _(j), to detect potential flag-able impairments basedon the patient's condition, and signal same back to the first responder14 _(k). To that end, the sensor unit 148 comprises a physical sensorpart 147 and a medical sensor part 149.

The physical sensor part 147 comprises one or more physical sensors forsensing one or more physical parameters (e.g., temperature, pressure,chemical concentration, electromagnetic radiation level such as lightintensity or hard radiation level, vibration level, etc.) and/or otherphysical activity (e.g., motion of a person or object) around thepatient pack 24 _(j) and for generating data indicative of these one ormore physical parameters and/or other physical activity. For example,the sensor unit 148 may comprise one or more of: temperature/heatsensors (e.g., to detect surrounding temperature); pressure sensors(e.g., to detect atmospheric pressure); chemical sensors (e.g., to senseconcentrations or traces of chemicals, such as explosive substances);mass/weight sensors (e.g., to sense mass/weight of persons or objects);vibration sensors (e.g., to sense ground vibrations); movement sensors(e.g., to sense movement of persons or objects); sound sensors (e.g., tosense voices, mechanical sounds, sounds from movement); visible lightsensors (e.g., to sense visible light intensity) infrared light sensors(e.g., to sense infrared light emitted by persons or objects or effectvideo surveillance); RF sensors (e.g., to sense RF emissions orinterference); hard radiation sensors (e.g., to sense x-rays, gamma raysor other hard radiation to effect Geiger counter/detection of nucleardecay, hidden object sensing); biotoxin sensors (e.g., to sense airborneor surface toxins, bacteria or viruses); cameras (e.g., to detectmovement or identify person or objects, for instance, to effect videosurveillance or provide imagery of the patient 18 _(j) to remoteclinicians at the healthcare facility 33); liquid sensors (e.g., tosense presence of water or other liquids); and gas/vapor sensors (e.g.,to sense presence of hazardous or harmful gases such as H₂S, CO, methaneor propane, and/or hazardous or harmful vapors or gases such aschlorine, fluorine, bromine or petroleum vapors; to sense inadequatelevels of oxygen, or presence of smoke or combustion products; etc).These examples are presented for illustrative purposes only as thephysical sensor part 147 may comprise sensors with various other sensingcapabilities.

The medical sensor part 149 comprises one or more physiological sensorsfor sensing one or more physiological parameters of the patient 18 _(j)and for generating data indicative of these one or more physiologicalparameters. For example, the sensor unit 148 may comprise one or moresensors for sensing a heart rate, blood pressure, body temperature,oxygenation level, breathing rate, or toxin level of the patient 18_(j), or for sensing any other physiological parameter relevant toevaluating the patient's medical condition (in that sense, thephysiological parameters sensed by the medical sensor part 149 can alsobe referred to as “medical parameters”). Each physiological sensor ofthe medical sensor part 149 may be strapped (e.g., to a wrist) orotherwise externally fixed on the patient's body and/or may be partiallyor entirely inserted into the patient's body (e.g., intradermally,intravenously). For instance, in some embodiments, various physiologicalsensors of the medical sensor part 149 may be included in a wristbracelet 39 worn by the patient 18 _(j) (which can also serve as an IDbracelet) and a patient monitor 37 wired to the patient 18 _(j), bothwirelessly connected (e.g., via a Bluetooth® or equivalent short-rangewireless link) to a wireless receiver of the medical sensor part 149.

The wireless interface 142 provides a bidirectional communicationcapability to connect the patient pack 24 _(j) to the ECAS outstations28 ₁ . . . 28 _(M) (e.g., to report location and sensor information).More particularly, the wireless interface 142 comprises a wirelesstransmitter to transmit wireless signals destined for one or more of theECAS outstations 28 ₁ . . . 28 _(M) and conveying data generated by thepatient pack 24 _(j), such as data derived from a wireless locationsignal received by its location receiver 143 (e.g., data related to atime of arrival of that signal) and/or data generated by its sensor unit148. Also, the wireless interface 142 comprises a wireless receiver toreceive wireless signals from one or more of the ECAS outstations 28 ₁ .. . 28 _(M) and conveying data destined for the patient pack 24 _(j),such as data indicative of commands to be executed by the patient pack24 _(j) (e.g., commands to activate/deactivate the location receiver 143and/or one or more sensors of the sensor unit 148).

The processing entity 150 performs various processing operations toimplement functionality of the patient pack 24 _(j). For example, theseprocessing operations may include operations to: process data generatedby the sensor unit 148 and data derived from a wireless location signalreceived by the location receiver 143 (e.g., data related to a time ofarrival of that signal); activate/deactivate components of the patientpack 24 _(j) (e.g., the location receiver 143 and/or one or more sensorsof the sensor unit 148); cause the wireless interface 142 to transmit awireless signal conveying data generated by the sensor unit 148 and/ordata derived from a wireless location signal received by the locationreceiver 143 (e.g., data related to a time of arrival of that signal);etc.

The processing operations may also implement a timing andsynchronization function to ensure that the location transmitter 141transmits wireless location signals at precise instants and that timesof arrival of wireless locations signals at the location receiver 143are accurately measured. This measurement may be made based on anabsolute timing reference that can be distributed amongst the packs 22 ₁. . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECASoutstations 28 ₁ . . . 28 _(M). Alternatively, the measurement may bemade relative to a local timing of the location transmitter 141, inwhich case a “relative” time of reception at the location receiver 143of a wireless location signal transmitted by an unlocated one of thepacks 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) can becaptured and forwarded to the processing system 20. Since it knows thetimes of reception of wireless location signals transmitted by thelocation transmitter 141 and has computed the location of thattransmitter, the processing system 20 can compute the distance to andhence time of flight from the location receiver 143 and thus candetermine, from the measured and reported relative time, the actual timeof arrival at the location receiver 143 of the wireless location signaltransmitted by the unlocated pack.

The processing entity 150 comprises one or more processors to performits various processing operations. A given one of these one or moreprocessors may be a general-purpose processor having access to a storagemedium (e.g., semiconductor memory, including one or more ROM and/or RAMmemory devices) storing program code for execution by that processor toimplement the relevant processing operations. Alternatively, a given oneof these one or more processors may be a specific-purpose processorcomprising one or more pre-programmed hardware or firmware elements(e.g., ASICs, EEPROMs, etc.) or other related elements to implement therelevant processing operations.

The power supply 144 comprises one or more batteries and/or other powerstorage elements to supply power to the various components of thepatient pack 24 _(j). The power supply 144 has a power capacity enablingthe patient pack 24 _(j) to be used as long as possible for purposes ofthe first response mission at the incident scene 12 (e.g., a few hoursto allow sufficient time to provide proper treatment to the patient 18_(j) and/or transport him/her to the healthcare facility 33). The powersupply 144 may also have charging circuitry to facilitate itsrecharging. The power supply 144 may also provide power by other means.For example, it may comprise powering elements to provide power based onsolar or vibrational energy, which can be used to supplement its primaryenergy source.

While in this embodiment the patient pack 24 _(j) comprises variouscomponents, in other embodiments, it may not comprise all of thesecomponents and/or may comprise different components. For example, insome embodiments, the patient pack 24 _(j) may comprise a communicationunit enabling the patient 18 _(j) to wirelessly communicate with thefirst responders 14 ₁ . . . 14 _(N) and/or remote clinicians or supportstaff at the healthcare facility 33 via the ECAS outstations 28 ₁ . . .28 _(M) and/or an emergency wireless network or a service providerwireless network (e.g., a system analogous to a hospital nurse-callsystem), when left unattended.

c) Drop Packs 26 ₁ . . . 26 _(R)

The drop packs 26 ₁ . . . 26 _(R) are optional components of the firstresponse support system 10 that can serve to improve the system'scoverage and resolution at the incident scene 12, both in terms oflocation-awareness and physical conditions sensing, irrespective ofwhether the first responders 14 ₁ . . . 14 _(N) remain at locationswhere they are dropped. For example, in cases where the first responsevehicles 16 ₁ . . . 16 _(M) have to stop some distance away from a “mainaction area” of the incident scene 12, the first responders 14 ₁ . . .14 _(N) may place multiple ones of the drop packs 26 ₁ . . . 26 _(R)between the first response vehicles 16 ₁ . . . 16 _(M) and the mainaction area to allow a concatenated extension of the location-awarenesscapability out to the main action area. As another example, multipleones of the drop packs 26 ₁ . . . 26 _(R) can be placed around or nearanticipated sources of hazardous conditions such as burning buildings orvehicles, leaking tanks of hazardous or combustible materials, etc. Asyet another example, multiple ones of the drop packs 26 ₁ . . . 26 _(R)can also be used to provide more data location data points and physicalconditions data points at the incident scene 12 (e.g., additional droppacks may be placed around a burning building before first responderssuch as firemen enter the building so as to provide very high locationcoverage through the building's walls to track the locations of thesefiremen).

FIG. 4 shows an embodiment of a drop pack 26 _(j) of the drop packs 26 ₁. . . 26 _(R) that is “dropped” (i.e., placed) at any suitable locationat the incident scene 12. Other ones of the drop packs 26 ₁ . . . 26_(R) may be similarly constructed.

The drop pack 26 _(j) comprises suitable hardware and software (whichmay include firmware) for implementing a plurality of functionalcomponents, including, in this embodiment, a location unit 240, anidentification unit 246, a sensor unit 248, a wireless interface 242, auser interface 252, a processing entity 250 and a power supply 244.These functional components may be embodied as a single portable deviceor combination of portable devices carried by a first responder 14 _(i)of the first responders 14 ₁ . . . 14 _(N) at the incident scene 12until it is dropped by the first responder 14 _(i) at any suitablelocation at the incident scene 12. For example, the single portabledevice or combination of portable devices constituting the drop pack 26_(j) may be arranged as a portable case to be carried by the firstresponder 14 _(i) until it is dropped at the incident scene 12. Adecision to drop the drop pack 26 _(j) at a given location may be madeby the first responder 14 _(i) or by the processing system 20 whichdetects that the first responder 14 _(i) is approaching limits of itsactive location area and commands the drop pack 26 _(j) to be dropped atthat given location. Exact placement of the drop pack 26 _(j) is notrequired since its location will be determined by the processing system20. In some cases, one or more other drop packs may be carried by thefirst responder 14 _(i) in addition to the drop pack 26 _(j) (e.g.,inside a single portable housing) and dropped at various locations atthe incident scene 12.

The location unit 240 enables the processing system 20 to determine alocation of the drop pack 26 _(j). To that end, the location unit 240comprises a location transmitter (e.g., pinger) 241 to transmit awireless location signal that allows the processing system 20 todetermine the location of the drop pack 26 _(j). For example, thewireless location signal may be a short RF burst or series of short RFbursts. More particularly, in this embodiment, the processing system 20determines the location of the drop pack 26 _(j) based on three or moretimes of arrival of the wireless location signal at three of morelocation receivers having known locations that distributed among some ofthe ECAS outstations 28 ₁ . . . 28 _(M) and/or other ones of the packs22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) usingtriangulation techniques. In other embodiments, rather than allow theprocessing system 20 to effect location computations based on times ofarrival of the wireless location signal transmitted by the locationtransmitter 241, the wireless location signal may convey other locationdata that indicates or can be used to compute the location of the droppack 26 _(j).

In addition, in this embodiment, once the drop pack 26 _(j) has beenlocated, the location unit 240 enables the processing system 20 todetermine locations of other ones of the packs 22 ₁ . . . 22 _(N), 26 ₁. . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range of the drop pack26 _(j). To that end, the location unit 240 comprises a locationreceiver (e.g., a location sensor) 243 to receive wireless locationsignals from location transmitters of other ones of the packs 22 ₁ . . .22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within range ofthe drop pack 26 _(j). As part of the aforementioned cascaded locationprocess (which is further discussed later on), once it has been locatedby the processing system 20, the drop pack 26 _(j) may transmit awireless signal to the processing system 20 on a basis of the wirelesslocation signals it receives from these location transmitters in orderto allow the processing system 20 to determine locations of those packs22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) from which itreceived the wireless location signals. As mentioned above, in order tominimize error propagation through the stages of the cascaded locationprocess, the location unit 240 may employ wireless technology allowing alocation of those packs within its range to be determined with anexcessive level of precision, such as 1 m or better (e.g., 50 cm or evenless), to permit a build-up of tolerances in a concatenated locationapproach to maintain an adequate final level of accuracy. For example,in this embodiment, the location unit 240 may employ UWB technology(e.g., a UWB tag) which offers increased accuracy, down to tens ofcentimeters or less.

The identification unit 246 provides identification data serving toidentify the drop pack 26 _(j). The identification data may comprise oneor more identifiers, such as an alphanumeric code (e.g., a UWB tag code,a serial number associated with the drop pack 26 _(j), etc.). Thewireless location signal transmitted by the location unit 240 of thedrop pack 26 _(j) may comprise the identification data (or data derivedtherefrom) to allow the processing system 20 to identify the drop pack26 _(j) it is locating. In this respect, while they are shown asseparate components, it will be recognized that in some embodimentsfunctionality of the identification unit 246 and the location unit 240(and particularly its location transmitter 241) may be implemented by acommon component (e.g., a UWB tag).

The sensor unit 248 enables the processing system 20 to understandphysical conditions of the incident scene 12 around the drop pack 26_(j), allowing detection of various inclement, adverse or hazardousconditions surrounding the drop pack 26 _(j), which may improve safetyof individuals such as one or more of the first responders 14 ₁ . . . 14_(N) or patients 18 ₁ . . . 18 _(P) who may be near the pack or headingor expected to head towards it.

More particularly, the sensor unit 248 comprises one or more physicalsensors for sensing one or more physical parameters (e.g., temperature,pressure, chemical concentration, electromagnetic radiation level suchas light intensity or hard radiation level, vibration level, etc.)and/or other activity (e.g., motion of a person or object) around thedrop pack 26 _(j) and for generating data indicative of these one ormore physical parameters and/or other physical activity. For example,the sensor unit 248 may comprise one or more of: temperature/heatsensors (e.g., to detect surrounding temperature); pressure sensors(e.g., to detect atmospheric pressure); chemical sensors (e.g., to senseconcentrations or traces of chemicals, such as explosive substances);mass/weight sensors (e.g., to sense mass/weight of persons or objects);vibration sensors (e.g., to sense ground vibrations); movement sensors(e.g., to sense movement of persons or objects); sound sensors (e.g., tosense voices, mechanical sounds, sounds from movement); visible lightsensors (e.g., to sense visible light intensity) infrared light sensors(e.g., to sense infrared light emitted by persons or objects or effectvideo surveillance); RF sensors (e.g., to sense RF emissions orinterference); hard radiation sensors (e.g., to sense x-rays, gamma raysor other hard radiation to effect Geiger counter/detection of nucleardecay, hidden object sensing); biotoxin sensors (e.g., to sense airborneor surface toxins, bacteria or viruses); cameras (e.g., to detectmovement or identify person or objects, for instance, to effect videosurveillance or provide imagery of a nearby patient to remote cliniciansat the healthcare facility 33); liquid sensors (e.g., to sense presenceof water or other liquids); and gas/vapor sensors (e.g., to sensepresence of hazardous or harmful gases such as H₂S, CO, methane orpropane, and/or hazardous or harmful vapors or gases such as chlorine,fluorine, bromine or petroleum vapors; to sense inadequate levels ofoxygen, or presence of smoke or combustion products; etc). Theseexamples are presented for illustrative purposes only as the sensor unit248 may comprise various sensors with various other sensingcapabilities.

The wireless interface 242 provides a bidirectional communicationcapability to connect the drop pack 26 _(j) to the ECAS outstations 28 ₁. . . 28 _(M) (e.g., to report location and sensor information). Moreparticularly, the wireless interface 242 comprises a wirelesstransmitter to transmit wireless signals destined for one or more of theECAS outstations 28 ₁ . . . 28 _(M) and conveying data generated by thedrop pack 26 _(j), such as data derived from a wireless location signalreceived by its location receiver 243 (e.g., data related to a time ofarrival of that signal) and/or data generated by its sensor unit 248.Also, the wireless interface 242 comprises a wireless receiver toreceive wireless signals from one or more of the ECAS outstations 28 ₁ .. . 28 _(M) and conveying data destined for the drop pack 26 _(j), suchas data indicative of commands to be executed by the drop pack 26 _(j)(e.g., commands to activate/deactivate the location receiver 243 and/orone or more sensors of the sensor unit 248).

The processing entity 250 performs various processing operations toimplement functionality of the drop pack 26 _(j). For example, theseprocessing operations may include operations to: process data generatedby the sensor unit 248 and data derived from a wireless location signalreceived by the location receiver 243 (e.g., data related to a time ofarrival of that signal); activate/deactivate components of the drop pack26 _(j) (e.g., the location receiver 243 and/or one or more sensors ofthe sensor unit 248); cause the wireless interface 242 to transmit awireless signal conveying data generated by the sensor unit 248 and/ordata derived from a wireless location signal received by the locationreceiver 243 (e.g., data related to a time of arrival of that signal);etc.

The processing operations may also implement a timing andsynchronization function to ensure that the location transmitter 241transmits wireless location signals at precise instants and that timesof arrival of wireless locations signals at the location receiver 243are accurately measured. This measurement may be made based on anabsolute timing reference that can be distributed amongst the packs 22 ₁. . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) and the ECASoutstations 28 ₁ . . . 28 _(M). Alternatively, the measurement may bemade relative to a local timing of the location transmitter 241, inwhich case a “relative” time of reception at the location receiver 243of a wireless location signal transmitted by an unlocated one of thepacks 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R) can becaptured and forwarded to the processing system 20. Since it knows thetimes of reception of wireless location signals transmitted by thelocation transmitter 241 and has computed the location of thattransmitter, the processing system 20 can compute the distance to andhence time of flight from the location receiver 243 and thus candetermine, from the measured and reported relative time, the actual timeof arrival at the location receiver 243 of the wireless location signaltransmitted by the unlocated pack.

The processing entity 250 comprises one or more processors to performits various processing operations. A given one of these one or moreprocessors may be a general-purpose processor having access to a storagemedium (e.g., semiconductor memory, including one or more ROM and/or RAMmemory devices) storing program code for execution by that processor toimplement the relevant processing operations. Alternatively, a given oneof these one or more processors may be a specific-purpose processorcomprising one or more pre-programmed hardware or firmware elements(e.g., ASICs, EEPROMs, etc.) or other related elements to implement therelevant processing operations.

The power supply 244 comprises one or more batteries and/or other powerstorage elements to supply power to the various components of the droppack 26 _(j). The power supply 244 has a power capacity enabling thedrop pack 26 _(j) to be used as long as possible for purposes of thefirst response mission at the incident scene 12 (e.g., several hours ordays or even a few weeks in case of a major disaster). The power supply244 may also have charging circuitry to facilitate its recharging. Thepower supply 244 may also provide power by other means. For example, itmay comprise powering elements to provide power based on solar orvibrational energy, which can be used to supplement its primary energysource (e.g., to keep powering the location transmitter 241 in caseswhere the drop pack's main power source has depleted, which can beuseful, for instance, in recovering the drop pack once the firstresponse mission is completed).

While in this embodiment the drop pack 26 _(j) comprises variouscomponents, in other embodiments, it may not comprise all of thesecomponents and/or may comprise different components.

ECAS Outstations 28 ₁ . . . 28 _(M)

The ECAS outstations 28 ₁ . . . 28 _(M) are transported to the incidentscene 12 by respective ones of the first response vehicles 16 ₁ . . . 16_(M) and provide communication, data processing and other functionalitybetween the packs 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26_(R) and the ECAS 30 (and other resources within the healthcare facility33). In particular, in this embodiment, the ECAS outstations 28 ₁ . . .28 _(M) enable communications between the incident scene 12 and thehealthcare facility 33, communications to and from the 22 ₁ . . . 22_(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R), reception of wirelesslocation signals to allow nearby ones of these packs to be located andthen activated so that their location receivers 43, 143, 243 cancontribute to extending the location-awareness area at the incidentscene 12, and collection, collation, filtering or other processing ofsensor information transmitted by these packs prior to sending this tothe ECAS 30 which creates a multi-environmental-plane view of theincident scene 12.

FIG. 5 shows an embodiment of an ECAS outstation 28 _(j) of the ECASoutstations 28 ₁ . . . 28 _(M) that is transported to the incident scene12 by a vehicle 16 _(j) of the vehicles 16 ₁ . . . 16 _(M). Other onesof the ECAS outstations 28 ₁ . . . 28 _(M) may be similarly constructed.

The ECAS outstation 28 _(j) comprises suitable hardware and software(which may include firmware) for implementing a plurality of functionalcomponents, including, in this embodiment, a plurality of pack locationunits 302 ₁ . . . 302 ₉, an outstation location unit 310, a plurality ofsensor units 320 ₁ . . . 320 ₉, a wireless pack interface 330, awireless ECAS interface 340, a processing entity 360 and a power supply370. These functional components may be embodied as equipment installedon the vehicle 16 _(j) so as to facilitate their transportation to theincident scene 12.

The pack location units 302 ₁ . . . 302 ₉ are arranged at differentpositions relative to one another and enable the processing system 20 todetermine the locations of individual ones of the packs 22 ₁ . . . 22_(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within theirrange. To that end, each of the pack location units 302 ₁ . . . 302 ₉comprises a location receiver 303 to receive wireless location signalstransmitted by location transmitters 41, 141, 241 of those packs 22 ₁ .. . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within itsrange. In order to determine the locations of the packs 22 ₁ . . . 22_(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), at least three andpreferably more (e.g., four, five or six) location receivers 303 need to“see” the wireless location signals transmitted by these packs. Theresolution or precision of the location computation typically dependsupon both the distance to the location transmitter 41, 141, 241 of thepack to be located and baseline distances between the location receivers303 which receive the wireless location signal transmitted by thatlocation transmitter.

More particularly, in this embodiment, the pack location units 302 ₆ . .. 302 ₉ are fixed at known locations on the vehicle 16 _(j). In thiscase, these locations are non-coplanar to allow location measurements in3D.

Also, in this embodiment, each of the pack location units 302 ₁ . . .302 ₅ is disposed on a tip region of a respective one of a plurality ofextensible arms (e.g., booms) 307 ₁ . . . 307 ₅ that are capable ofbeing extended relative to a body of the vehicle 16 _(j). The extensiblearms 307 ₁ . . . 307 ₄ extend substantially horizontally from respectivecorner regions of the body of the vehicle 16 _(j) and are dimensioned togive a certain spread (e.g., 20 to 25 ft) about the body of vehicle 16_(j). This can be done to increase differential path lengths fromlocation receivers to be located and thereby extend a coverage area ofsufficient location discrimination by the location receivers 303 of thepack location units 302 ₁ . . . 302 ₄. The extensible arm 307 ₅ extendssubstantially vertically from a center region of the body of the vehicle16 _(j) to allow the location receiver 303 of the pack location unit 302₅ to be used in determining z-coordinates of those packs from which itreceives wireless location signals. The extensible arms 307 ₁ . . . 307₅ thus provide longer baseline distances between the location receivers303 of the pack location units 302 ₁ . . . 302 ₅, thereby providinggreater precision and location discrimination out to a greater range.

The locations of the pack location units 302 ₁ . . . 302 ₅ on theextensible arms 307 ₁ . . . 307 ₅ have to be known very accurately ifthese pack location units are to enable the processing system 20 toaccurately determine the locations of those packs 22 ₁ . . . 22 _(N), 26₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) that are within their range. Thiscan be achieved in various ways. For example, in this embodiment, eachof the pack location units 302 ₁ . . . 302 ₅ comprises a locationtransmitter (e.g., pinger) 306 to transmit a wireless location signalallowing the processing system 20 to determine a location of that packlocation unit. In this case, the processing system 20 determines thelocation of each of the pack location units 302 ₁ . . . 302 ₅ based ontimes of arrival of the wireless location signal transmitted by itslocation transmitter 306 at three or more of the location receivers 303of the pack location units 302 ₆ . . . 302 ₉ at known locations on thevehicle 16 _(j) using triangulation techniques. In other embodiments,the locations of the pack location units 302 ₁ . . . 302 ₅ may be knownto the processing system 20 based on engineering and other informationregarding the extensible arms 307 ₁ . . . 307 ₅, such as their actualextension length and orientation, without having to process wirelesslocation signals transmitted by location transmitters such as thelocation transmitters 306, in which case such location transmitters maybe omitted. In yet other embodiments, rather than allow the processingsystem 20 to effect location computations based on times of arrival ofthe wireless location signal transmitted by each of the pack locationunits 302 ₁ . . . 302 ₅, this wireless location signal may convey datathat indicates or otherwise allows computation of the location of thatpack location unit (e.g., precise angle of arrival of the signal at eachreceiver or the signal strength at the receiver, based on clearline-of-sight measurements only or a combination of these).

In the aforementioned cascaded location process which is furtherdetailed later on, the pack location units 302 ₁ . . . 302 ₉ receivewireless location signals from those packs 22 ₁ . . . 22 _(N), 26 ₁ . .. 26 _(R), 24 ₁ . . . 24 _(P) that are within their range and, based ondata derived from these signals (e.g., data relating to their times ofarrival at the location receivers 303), the processing entity 360 of theECAS outstation 28 _(j) and/or the ECAS 30 (depending on whether local,remote or distributed location computation is used) can compute thelocation of each of these packs. Once the locations of these packs aredetermined, the ECAS outstation 28 _(j) can activate the locationreceivers 43, 143, 243 of these packs and add their measurements to thelocation computation capability.

As mentioned above, in order to minimize error propagation through thestages of the cascaded location process, the pack location units 302 ₁ .. . 302 ₉ may employ wireless technology allowing a location of thosepacks within its range to be determined with an excessive level ofprecision, such as 1 m or better (e.g., 50 cm or even less), to permit abuild-up of tolerances in a concatenated location approach to maintainan adequate final level of accuracy. For example, in this embodiment,the pack location units 302 ₁ . . . 302 ₉ may employ UWB technology(e.g., UWB tags) which offers increased accuracy, down to tens ofcentimeters or less.

The outstation location unit 310 allows a location of the ECASoutstation 28 _(j) to be determined by the processing system 20. Thislocation can be an absolute location or a relative location (relative toan arbitrary site reference), and in some cases may be accompanied by anorientation of the ECAS outstation 28 _(j).

For example, in this embodiment, the outstation location unit 310 maycomprise a GPS receiver (with an optional gyroscopic compass) enablingthe absolute location (and optionally the orientation) of the ECASoutstation 28 _(j) to be determined based on GPS signaling. As the GPSreceiver (e.g., a civilian GPS receiver) may yield approximate results,once the ECAS outstation 28 _(j) has been located, other ones of theECAS outstations 28 ₁ . . . 28 _(M) may have to locate themselvesprecisely relative to the ECAS outstation 28 _(j) by means other thanGPS so as to establish accurate baselines between the ECAS outstations28 ₁ . . . 28 _(M) to allow their precise relative location to bedetermined so that location collaboration between them is possible (asdescribed below) to locate packs in intervening spaces between them orto locate packs far away whereby a long baseline is needed shouldcascaded location not be available. Also, after a precision location mapis built up, this can be used to augment the precision of the absolutelocation of the ECAS outstation 28 _(j) (e.g., the ECAS outstation 28_(j) may determine from GPS signaling that its location is within +/−10meters of 120 meters south of the south wall of 321 Metcalfe Street,but, by measuring the relative location of a drop pack placed at thewall of 321 Metcalfe Street, it may determine that the range to thatpack (and hence 321 Metcalfe Street) is 112.3 meters+/−0.7 meters,allowing it to correct its position to being 111.6 to 113 meters southof 321 Metcalfe Street). Furthermore, by using cascaded locationcapabilities on located ones of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . .26 _(R), 24 ₁ . . . 24 _(P), combined with an accurate relative locationof the ECAS outstations 28 ₁ . . . 28 _(M), if the locations of allthese packs is known relative to any ECAS outstation, they may be knownrelative to all these ECAS outstations. Thus, any one of the firstresponse vehicles 16 ₁ . . . 16 _(M) (except the last one) can leave theincident scene 12 as it is loaded with one or more patients, and thelocation grid will keep operating since those ones of the packs 22 ₁ . .. 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) at known locations canbridge across the gap left and report further locations to the remainingvehicles.

In other embodiments, the outstation location unit 310 may comprise alocation receiver and a location transmitter to exchange wirelesslocation signals with other ones of the ECAS outstations 28 ₁ . . . 28_(M) to allow the absolute or relative location of the ECAS outstation28 _(j) to be determined on a basis of times of arrival of these signalsthrough collaboration between the ECAS outstations 28 ₁ . . . 28 _(M).In yet other embodiments, relative placement and orientation of the ECASoutstation 28 _(j) can be determined from a reference point (e.g. thefirst one of the first response vehicles 16 ₁ . . . 16 _(M) on site) bymeasuring direction and distance to that reference point combined withthe orientation of the vehicle 16 _(j) to that reference point (e.g., ifthe reference point is one of the first response vehicles 16 ₁ . . . 16_(M), this can be done by use of a high gain/high power version of a UWBlocation system, which may have a range of up to 1 km or more). In yetother embodiments, the location of the ECAS outstation 28 _(j) can bedetermined with reference to a city level or site level map or withreference to cellular, WiMax or other wireless location technologiesthat may be available, possibly with appropriate augmentation similar tothat applied to the GPS case above to increase location precision oncethe location grid is established. Location data indicative of thelocation of the ECAS outstation 28 _(j) may be transmitted to the ECAS30 via the wireless ECAS interface 340 and/or used locally by the ECASoutstation 28 _(j) to make location computations.

Each of the sensor units 320 ₁ . . . 320 ₉ enables the processing system20 to understand physical conditions of the incident scene 12 around thevehicle 16 _(j), allowing detection of various inclement, adverse orhazardous conditions surrounding the vehicle 16 _(j), which may improvesafety of individuals such as one or more of the first responders 14 ₁ .. . 14 _(N) or patients 18 ₁ . . . 18 _(P) who may be in or near thevehicle 16 _(j) or heading or expected to head towards it. The sensorunits 320 ₁ . . . 320 ₉ may be co-located with the pack location units302 ₁ . . . 302 ₉ or located at other locations.

More particularly, each of the sensor units 320 ₁ . . . 320 ₉ comprisesone or more sensors for sensing one or more physical parameters (e.g.,temperature, pressure, chemical concentration, electromagnetic radiationlevel such as light intensity or hard radiation level, vibration level,etc.) and/or other physical activity (e.g., motion of a person orobject) around that sensor unit and generating data indicative of theseone or more physical parameters and/or other physical activity. Forexample, each of the sensor units 320 ₁ . . . 320 ₅ may comprise one ormore of: temperature/heat sensors (e.g., to detect surroundingtemperature); pressure sensors (e.g., to detect atmospheric pressure);chemical sensors (e.g., to sense concentrations or traces of chemicals,such as explosive substances); mass/weight sensors (e.g., to sensemass/weight of persons or objects); vibration sensors (e.g., to senseground vibrations); movement sensors (e.g., to sense movement of personsor objects); sound sensors (e.g., to sense voices, mechanical sounds,sounds from movement); visible light sensors (e.g., to sense visiblelight intensity) infrared light sensors (e.g., to sense infrared lightemitted by persons or objects or effect video surveillance); RF sensors(e.g., to sense RF emissions or interference); hard radiation sensors(e.g., to sense x-rays, gamma rays or other hard radiation to effectGeiger counter/detection of nuclear decay, hidden object sensing);biotoxin sensors (e.g., to sense airborne or surface toxins, bacteria orviruses); cameras (e.g., to detect movement or identify person orobjects, for instance, to effect video surveillance or provide imageryof a nearby patient to remote clinicians at the healthcare facility 33);liquid sensors (e.g., to sense presence of water or other liquids); andgas/vapor sensors (e.g., to sense presence of hazardous or harmful gasessuch as H₂S, CO, methane or propane, and/or hazardous or harmful vaporsor gases such as chlorine, fluorine, bromine or petroleum vapors; tosense inadequate levels of oxygen, or presence of smoke or combustionproducts; etc). These examples are presented for illustrative purposesonly as each of the sensor units 320 ₁ . . . 320 ₉ may comprise physicalsensors with various other sensing capabilities.

The wireless pack interface 330 enables the ECAS outstation 28 _(j) towirelessly communicate with those packs 22 ₁ . . . 22 _(N), 26 ₁ . . .26 _(R), 24 ₁ . . . 24 _(P) that are within its range. To that end, thewireless pack interface 330 comprises a wireless receiver to receivewireless signals transmitted by some of the packs 22 ₁ . . . 22 _(N), 26₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) and conveying data generated bythese packs, such as data derived from wireless location signalsreceived by their location receivers 43, 143, 243, data generated bytheir sensor units 48, 148, 248, and/or data derived from input made bythe first responders 14 ₁ . . . 14 _(N) via the user interface 52 oftheir first responder packs. In addition, the wireless pack interface330 comprises a wireless transmitter to transmit wireless signalsconveying data destined for some of the packs 22 ₁ . . . 22 _(N), 26 ₁ .. . 26 _(R), 24 ₁ . . . 24 _(P), such as data indicative of informationto be presented to the first responders 14 ₁ . . . 14 _(N) via the userinterface 52 of their first responder packs (e.g., information regardingactions to be performed, such as administering certain medical treatmentto one or more of the patients 18 ₁ . . . 18 _(P), transporting one ormore of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility,moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P)to a different location, etc.) and/or data indicative of commands to beexecuted by those packs (e.g., commands to activate/deactivate theirlocation receivers 43, 143, 243 and/or one or more sensors of theirsensor units 48, 148, 248).

The wireless ECAS interface 340 enables the ECAS outstation 28 _(j) towirelessly communicate with the ECAS 30 over the wireless communicationlink 32, which, for instance, may be implemented by a dedicatedemergency services link or a publicly available link. More particularly,the wireless ECAS interface 340 comprises a wireless transmitter totransmit to the ECAS 30 wireless signals conveying data for processingat the ECAS 30, such as: data derived from wireless location signalsreceived by the location receivers 43, 143, 243, 303 (e.g., data relatedto time of arrivals of these signals) to establish locations of some ofthe packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P);data generated by the sensor units 48, 148, 248 of these packs and bythe sensor units 320 ₁ . . . 320 ₉ of the ECAS outstation 28 _(j);and/or data derived from input made by the first responders 14 ₁ . . .14 _(N) via the user interface 52 of their first responder packs. Thewireless ECAS interface 340 also comprises a wireless receiver toreceive wireless signals from the ECAS 30 and conveying data for uselocally at the incident scene 12, such as data indicative of informationto be presented to some of the first responders 14 ₁ . . . 14 _(N) viathe user interface 52 of their first responder packs (e.g., informationregarding actions to be performed, such as administering certain medicaltreatment to one or more of the patients 18 ₁ . . . 18 _(P),transporting one or more of the patients 18 ₁ . . . 18 _(P) to a givenhealthcare facility, moving himself/herself or one or more of thepatients 18 ₁ . . . 18 _(P) to a different location, etc.) and/or dataconveying commands to be executed by some of the packs 22 ₁ . . . 22_(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) (e.g., commands toactivate/deactivate their location receivers 43, 143, 243 and/or one ormore sensors of their sensor units 48, 148, 248).

While in this embodiment each of the ECAS outstations 28 ₁ . . . 28 _(M)communicates with the ECAS 30 via the wireless communication link 32, inother embodiments, one or more of these ECAS outstations may communicatewith the ECAS 30 via a communication link that is entirely wired or thatis partly wired and partly wireless (e.g., established over one or moreof a fiber optic metropolitan network or other wired network, a WiMax,cellular or other wireless network, or an emergency band connection).

The processing entity 360 performs various processing operations toimplement functionality of the ECAS outstation 28 _(j). These processingoperations include operations to cause the wireless ECAS interface 340to transmit wireless signals to the ECAS 30 based on wireless signalsreceived by the ECAS outstation 28 _(j) from individual ones of packs 22₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P). As furtherdiscussed below, the ECAS 30 processes data derived from the wirelesssignals it receives from the ECAS outstation 28 _(j) (possibly inconjunction with data derived from wireless signals it receives fromother ones of the ECAS outstations 28 ₁ . . . 28 _(M)) in order todetermine one or more actions to be taken with respect to the firstresponse mission.

In this embodiment, the processing entity 360 relays to the ECAS 30 datait derives from wireless signals it receives from the individual ones ofthe packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P).This data may include data derived from wireless location signalsreceived by the location receivers 43, 143, 243, 303 (e.g., data relatedto time of arrivals of these signals) to establish locations of some ofthe packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P);data generated by the sensor units 48, 148, 248 of these packs and bythe sensor units 320 ₁ . . . 320 ₉ of the ECAS outstation 28 _(j);and/or data derived from input made by the first responders 14 ₁ . . .14 _(N) via the user interface 52 of their first responder packs. Thatis, in this embodiment, the ECAS outstation 28 _(j) acts as a datacollection and relay point whereby the processing entity 360 performsrelatively simple processing operations to collect data derived fromwireless signals transmitted by individual ones of the packs 22 ₁ . . .22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), possibly formats thecollected data, and relay the collected (and possibly formatted) data tothe ECAS 30 where it is more extensively processed. In otherembodiments, the processing entity 360 may perform more extensiveprocessing operations. For example, in some embodiments, the processingentity 360 may locally perform location computations based on datarelated to time of arrivals of wireless location signals at locationreceivers 43, 143, 243, 303 of individual ones of packs 22 ₁ . . . 22_(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) and the ECAS outstation 28_(j) to generate location data indicating the locations of these packsand may transmit wireless signals conveying the generated location datato the ECAS 30.

In addition, the processing operations performed by the processingentity 360 include operations to cause the wireless pack interface 330to transmit wireless signals conveying data destined for individual onesof the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P),such as data indicative of information to be presented to firstresponders via the user interface 52 of these first responder packsand/or data indicative of commands to be executed by these packs, on abasis of wireless signals from the ECAS 30. As further discussed below,such wireless signals received from the ECAS 30 may have beentransmitted by the ECAS 30 upon determining one or more actions to betaken with respect to the first response mission.

The processing entity 360 comprises one or more processors to performits various processing operations. A given one of these one or moreprocessors may be a general-purpose processor having access to a storagemedium (e.g., semiconductor memory, including one or more ROM and/or RAMmemory devices) storing program code for execution by that processor toimplement the relevant processing operations. Alternatively, a given oneof these one or more processors may be a specific-purpose processorcomprising one or more pre-programmed hardware or firmware elements(e.g., ASICs, EEPROMs, etc.) or other related elements to implement therelevant processing operations.

The power supply 370 comprises one or more batteries and/or other powergeneration elements to supply power to the various components of theECAS outstation 28 _(j). The power supply 370 has a power capacitysufficient to enable the ECAS outstation 28 _(j) to be used for purposesof the first response mission at the incident scene 12. The power supply370 may also have charging circuitry to facilitate its recharging.

While in this embodiment the ECAS outstation 28 _(j) comprises variouscomponents, in other embodiments, it may not comprise all of thesecomponents and/or may comprise different components.

ECAS 30

FIG. 6 shows an embodiment of the ECAS 30, which, in this embodiment, islocated at the healthcare facility 33 remote from the incident scene 12.

The ECAS 30 comprises a processing entity 420 having access to a sensorsystem 260, a communication system 208 and an institutional informationsystem 200 of the healthcare facility 33 in order to provide variousservices within the healthcare facility 33. In accordance with anembodiment of the invention, the processing entity 420 of the ECAS 30also utilizes a wireless outstation interface 400 linked to the ECASoutstations 28 ₁ . . . 28 _(M) at the incident scene 12 via the wirelesscommunication links 32 in order to provide various services in relationto the first response mission at the incident scene 12.

Generally speaking, the ECAS 30 uses location data, physical environmentdata and communication data derived from the sensor system 260, thecommunication system 208 and the wireless outstation interface 400(i.e., from the ECAS outstations 28 ₁ . . . 28 _(M) at the incidentscene 12) as well as institutional data from the institutionalinformation system 20 such as policies, guidelines, user lists andprofiles, etc., in order to render significant and useful decisionsconcerning services provided within the healthcare facility 33 or inrelation to the first response mission at the incident scene 12.Specifically, the ECAS 30 enables decisions to be made regarding whatactions should be taken that are consistent with a particular service,when certain “situations” are deemed to occur, based on data relating tothe particular service that is derived from the sensor system 260, thecommunication system 208 and/or the wireless outstation interface 400.

The decisions taken by the ECAS 30 can result in adaptation oroptimization of communications taking place in the communication system208 and/or involving the first responders 14 ₁ . . . 14 _(N) at theincident scene 12, which may or may not be to such an extent as toenable improved, enhanced or even new clinical workflows and processesto result. This may mean preferentially feeding appropriate informationto an authenticated user (including information determined to berelevant to the user's situation), preventing communications to aninappropriate user, adapting communications to the circumstances of theuser or the user's equipment, establishing machine-to-machinecommunication with unattended equipment, initiating communications whencertain circumstances arise, and so on.

In this manner, the ECAS 30 can provide adaptive, smart communications,based upon environmental awareness on plural environment-planes(including a location plane and a physical environment plane) anddeduced situations, as well as access to permissions andauthorization/authentication profiles, policy databases and otherinstitutional information. Thus, services can be provided that adapt tothe actual communications needs of users, such as clinicians at thehealthcare facility 33 and the first responders 14 ₁ . . . 14 _(N) atthe incident scene 12, taking into account both an environment in whichthey operate and their clinical workflow state.

An understanding of application of an ECAS such as the ECAS 30 to ahealthcare facility such as the healthcare facility 33, as well asdetails regarding services that can be provided within the healthcarefacility, can be obtained by consulting U.S. patent application Ser. No.12/003,206 entitled “METHODS AND SYSTEMS FOR USE IN THE PROVISION OFSERVICES IN AN INSTITUTIONAL SETTING SUCH AS A HEALTHCARE FACILITY”,filed on Dec. 20, 2007 by Graves et al., and hereby incorporated byreference herein.

In accordance with an embodiment of the invention, the ECAS outstations28 ₁ . . . 28 _(M) in cooperation with the packs 22 ₁ . . . 22 _(N), 26₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) enable capabilities of the ECAS 30to be extended into the first response area at the incident scene 12.This allows the ECAS 30 to provide services relevant to the firstresponse mission at the incident scene 12 (some of which being analogousto services provided within the healthcare facility 33, while others arespecific to first response scenarios), thereby optimizing communicationsinvolving the first responders 14 ₁ . . . 14 _(N) and increasing firstresponder effectiveness, quality of care to patients, patient/firstresponder safety, speed of processing and overall first response sitesafety.

The aforementioned components of the ECAS 30, as well as examples ofservices which can be provided by the ECAS 30, will now be discussed ingreater detail.

a) Institutional Information System 200

The institutional information system 200 manages institutionalinformation pertaining to the healthcare facility 33. More particularly,in this embodiment, the institutional information system 200 comprises ahealthcare information system (HIS) 202, a healthcare clinicalinformation system (HCIS) 204, and a radiology system 206.

The HIS 202 may comprise databases for storing a variety of data,examples of which include general institution data, such as financialdata, building maintenance schedules, and so on. The HIS 202 may alsocomprise databases for storing information about which clinicians (i.e.,doctors, nurses, first responders and other medical professionals) areaccredited, what their rights and privileges are, their work scheduleand preferences (including their IT preferences), etc. The databases inthe HIS 202 may also contain information about other healthcare facilitysupport staff, such as orderlies, maintenance staff, administrativestaff, or biomedical engineers. The databases in the HIS 202 may alsocontain information about visiting clinicians who have approval to workin the healthcare facility 33, yet are not formally part of thefacility's staff. In that sense, the databases in the HIS 202 cancontain information on dynamic/interim users, data, rights andprivileges, as well as more formal and more permanent users, data,rights and privileges. The databases in the HIS 202 do not containclinical information about a patient base of the healthcare facility 33although they may contain non-clinical data about the patient base.

The HCIS 204 may include: a healthcare clinical information system(HCIS) core, which links and supports clinical databases of multipledepartments and databases; departmental systems, many of which may havebeen acquired as stand-alone functions and may have had to have beensubsequently integrated together; local Electronic Health Records(EHRs—or Electronic Patient Records (EPRs)) for patients in thehealthcare facility 33 or who have been treated by the healthcarefacility 33; test laboratory IT systems and databases with theirdifferent functions, modalities and outputs; firewalled secure gatewaysout to other locations for connectivity to centralized businesscontinuity/disaster recovery (BC/DR), remote centralized EHR, etc.

The HIS 202 and the HCIS 204 may thus comprise databases for storing avariety of data, examples of which include: policies (which defineactions to be taken under various situations and for various services inorder to achieve desired results); lists of entities (such as doctors,nurses, medical equipment) and associated IDs and AAA information;patient medical status; patient test data; patient schedule data;patient-clinician association data; EHR data; EPR data; EMR data(clinical-based applications); ordered patient treatment data; diagnosisdata; prognosis data; staff skills lists; and duty rosters.

These examples of data that may be stored in the HIS 202 and the HCIS204 are presented for illustrative purposes only as various other datamay be stored in these systems. For example, the databases in the HIS202 and the HCIS 204 may also store policies which describe minimal andoptimal combinations of resources (including people, machines, data,network, etc.) to perform certain functions. For instance, the formationof a “Code Blue” team requires certain clinicians and equipment to bereserved within a severely limited time to try and save a patient'slife. Other “code names” have their own requirements as well as otherprocesses. It should be appreciated that although the “code names” varybetween clinical jurisdictions, a healthcare facility's underlying needfor the associated services does not. The names used here are those usedas of 2005 in the Doctors Hospital, Columbus, Ohio.

The radiology system 206 comprises a suite of non-visible light imagingmodalities, such as X-ray, Magnetic Resonance Imaging (MRI), ComputedTomography (CT) scan, Positron Emission Tomography (PET)-scan as well asa Radiology Information System (RIS) which may include a PictureArchiving and Communication System (PACS) to move imaging data betweenmodalities and diagnostic terminals and radiologists as well asarchiving and accessing information stored in a radiology informationdatabase.

b) Communication System 208

The communication system 208 provides communication capabilitiesthroughout the healthcare facility 33. For example, this can be achievedby one or more of the following communication networks:

-   -   voice network;    -   data network;    -   converged multimedia network: may use VoIP soft switches to        provide voice services, which in turn provides more opportunity        for communication sessions via SIP;    -   regional and metro networks: many healthcare facilities are        geographically diverse or operate on multiple campuses or have        regional operating entities or fall under common administration.        Thus, there can be an inter-institutional metropolitan network,        which may consist of high-capacity fiber links between        healthcare facilities and data centers, for the purposes of data        storage, PACS and health records systems, disaster recovery,        voice communications, etc. The metropolitan network also allows        the healthcare facilities to communicate with EMS and city        services;    -   video conferencing and telemedicine network: a specialized        infrastructure may exist to support video conferencing and        telemedicine systems requiring higher resolution and/or        time-sensitive performance;    -   wireless network: an example of a wireless local area network        (WLAN) for voice and data point-of care applications.        WLAN-capable user equipment integrate with, for example, nurse        call systems which send informative text to the WLAN-capable        user equipment as the nurse is being called. Other examples        include cell phones or smart phones, which can be used for        scheduling and contact in the WLAN;    -   legacy paging system;    -   equipment monitoring network: some equipment uses legacy 802.11        standards for point-to-point communications (e.g. wireless EKG        monitors). Equipment such as infusion pumps may or may not        contain an 802.11 WLAN communications capability; and    -   clinical and virtual private network (VPN) access: satellite        clinics access the HIS 202 and HCIS 204 via Ti, digital        subscriber line (DSL), or VPN. For remote clinicians, such as        outpatient nurses, personal VPN access over the cellular data        network can be used.

These examples of networks which may enable the communication system 208to provide communication capabilities throughout the healthcare facility33 are presented for illustrative purposes only as various othernetworks may be used to provide such communication capabilities.

c) Sensor System 260

The sensor system 260 senses and collects data primitives about variousenvironment planes (including a location plane, a physical environmentplane that takes into account heat/temperature, humidity, light,radiation, presence of specific gases or compounds, physical states suchas door openings and other physical aspects of the environment, and aphysiological plane in respect of patients within the healthcarefacility 33) and filters or otherwise pre-processes these dataprimitives to a point where they can be fed to the processing entity420.

To that end, the sensor system 260 comprises various sensors distributedthroughout the healthcare facility 33 to provide a sensory awareness inmultiple environment planes within the healthcare facility 33, such aslocation and/or movement of people and objects, physical parameters(e.g., temperature, pressure, radiation level, chemical concentrations,etc.) in the healthcare facility 33, physiological parameters (e.g.,heart rate, blood pressure, toxin levels) of patients in the healthcarefacility 33, etc. For example, the sensor system 260 may comprise one ormore of:

-   -   location sensors (with reception and possibly transmission        capabilities): absolute location or relative location (e.g.,        proximity sensors), active and passive;    -   cameras: movement detection and object identification using        picture and video or processed derivations of components        therein;    -   clinical sensors including stand-alone, on-body, in-body        (ingestible or implanted) and on-equipment sensors;    -   sound sensors: voices, mechanical sounds, sounds from movement;    -   vibration sensors: fence vibrations, ground vibrations from        intrude inadvertent interaction;    -   movement sensors: motion sensors, contact openings, closings,        e.g., on gates, doors, entry points;    -   visible light sensors: video surveillance (manual or automatic        analysis), photobeam disruption;    -   infra-red light sensors: video surveillance (manual or automatic        analysis), photobeam disruption, changes in reflected energy,        self-radiation (hot persons, objects);    -   wireless signals: interaction of objects, personnel with RF        fields (quasi-radar or interferometric), active RF emissions        (inadvertent/clandestine or deliberate/IFF);    -   mass/weight/pressure sensors: ground perimeter pressure sensors        for personnel, objects with significant mass, matching mass to        expected mass;    -   chemical sensors: chemical trace analysis, explosives detection;    -   biotoxin sensors: airborne, surface bacteria, virus sensing;    -   hard radiation sensors: Geiger counter/detection of nuclear        decay, hidden object sensing (X-ray, nuclear scanners);    -   liquids/fluids/water sensors: fluid sensors/floats, humidity        sensing; and gas/vapor sensors: hazardous gas detection (e.g.,        H2S sensor, CO sensor or sensors for more problematic gases).

These examples of sensors are presented for illustrative purposes onlyas the sensor system 260 may comprise various other types of sensors tosense various aspects of the healthcare facility 33. Also, some of theseor other sensors may be accompanied by complementary actuators (e.g.,door position sensors may be accompanied by door lock actuators).

At the incident scene 12, the sensor units and location units of thepacks 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P) and theECAS outstations 28 ₁ . . . 28 _(M) as well as the processing entities360 of the ECAS outstations 28 ₁ . . . 28 _(M) can collaborate toimplement functionality similar to a distributed version of thefunctionality of the sensor system 260 of the healthcare facility 33.

d) Wireless Outstation Interface 400

The wireless outstation interface 400 enables the ECAS 30 to wirelesslycommunicate with the ECAS outstations 28 ₁ . . . 28 _(M) over thewireless communication links 32, either directly or via an interposednetwork which may be wireless or wired (e.g., a fiber optic metropolitannetwork or other wired network, a WiMax, cellular or other wirelessnetwork, or an emergency band connection).

More particularly, in this embodiment, the wireless outstation interface400 comprises a wireless receiver to receive wireless signalstransmitted by the ECAS outstations 28 ₁ . . . 28 _(M) and conveyingdata regarding the incident scene 12, such as data derived from wirelesslocation signals received by the location receivers 43, 143, 243, 303(e.g., data related to time of arrivals of these signals) to establishlocations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . .. 24 _(P); data generated by the sensor units 48, 148, 248 of thesepacks and by the sensor units 320 ₁ . . . 320 ₉ of the ECAS outstations28 ₁ . . . 28 _(M); and/or data derived from input made by the firstresponders 14 ₁ . . . 14 _(N) via the user interface 52 of their firstresponder packs. The wireless ECAS interface 340 also comprises awireless transmitter to transmit wireless signals destined for the ECASoutstations 28 ₁ . . . 28 _(M) and conveying data for use at theincident scene 12, such as data indicative of information to bepresented to the first responders 14 ₁ . . . 14 _(N) via the userinterface 52 of their first responder packs (e.g., information regardingactions to be performed, such as administering certain medical treatmentto one or more of the patients 18 ₁ . . . 18 _(P), transporting one ormore of the patients 18 ₁ . . . 18 _(P) to a given healthcare facility,moving himself/herself or one or more of the patients 18 ₁ . . . 18 _(P)to a different location, etc.) and/or data conveying commands to beexecuted by the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . .24 _(P) (e.g., commands to activate/deactivate their location receivers43, 143, 243 and/or one or more sensors of their sensor units 48, 148,248).

In other embodiments, such as those where the ECAS 30 interfaces to awired network feeding a local wireless drop to the ECAS outstations 28 ₁. . . 28 _(M), the wireless outstation interface 400 may be replaced byan equivalent wired network access interface.

e) Processing Entity 420

Through interaction with the sensor system 260, the communication system208, the wireless outstation interface 400 and the institutionalinformation system 200, the processing entity 420 of the ECAS 30provides various services within the healthcare facility 33 and, inaccordance with an embodiment of the invention, various services inrelation to first response missions such as the first response missionat the incident scene 12.

FIG. 7A shows examples of services that can be provided by the ECAS 30within the healthcare facility 33, including:

-   -   a “clinician tracking” service: tracks the locations of        clinicians, such as doctors, nurses and other clinicians within        the healthcare facility 33;    -   a “patient tracking and/or monitoring” service; tracks the        locations and/or monitors the conditions of patients within the        healthcare facility 33;    -   an “equipment tracking and/or monitoring” service; tracks the        locations and/or monitors the conditions of equipment within the        healthcare facility 33;    -   an “equipment/clinician, equipment/patient or clinician patient        association” service: monitors associations between clinicians,        patients and equipment at the healthcare facility 33;    -   a “clinician point of care communications” service: implements        tools enabling clinicians to access information and perform        clinical tasks (e.g., decisions, treatment orders, etc.) at the        point of care of patients within the healthcare facility 33);    -   a “clinical collaboration” service: implements tools enabling        collaboration between clinicians at the healthcare facility 33;    -   a “code blue/pink—emergency cardiac/respiratory        event—adult/pediatric” service: performs various actions,        including identification and location of the code blue/pink        event and victim and communication to form a code blue/pink team        within the healthcare facility 33;    -   a “code Adam—missing infant or child” service: acts to prevent        abduction or loss of infants within the healthcare facility 33        (e.g., by tracking them) and to find a missing infant when        he/she goes missing (e.g., by issuing alerts);    -   a “code brown—wandering patient protection” service: acts to        prevent wandering of patients within the healthcare facility 33        (e.g., by tracking them) and to find a missing patient when        he/she goes missing (e.g., by issuing alerts);    -   a “code yellow—disaster response” service: performs actions to        prepare the healthcare facility 33 for incoming casualties,        including communications to form the code yellow team, and to        support the code yellow team during initial treatment of        incoming casualties;    -   a “code red—fire” service: detects, assesses and tracks a fire        at the healthcare facility 33 or remote therefrom (e.g., at the        incident scene 12) and issues communications to respond to the        fire (e.g., alerts, areas and directions to evacuate, commands        to close doors, control ventilation, validate via the location        sensing system that all locatable clinicians, staff and patients        are evacuated from evacuation areas, identification of the        location of locatable hazardous or inflammable material relative        to the fire);    -   a “code orange—hazardous material” service: detects, assesses        and tracks hazardous material at the healthcare facility 33 or        remote therefrom (e.g., at the incident scene 12) and issues        communications to respond to the hazardous material (e.g.,        alerts, areas and directions to evacuate, commands to close        doors, control ventilation, validate via the location sensing        system that all locatable clinicians, staff and patients are        evacuated from evacuation areas);    -   a “drug safety, security and environment” service: tracks drugs        within the healthcare facility 33 or remote therefrom (e.g., at        the incident scene 12), manages their inventory and protects        them from being misplaced, stolen or exposed to harmful        environmental conditions; and    -   an “equipment theft or movement outside of authorized        zone—detection” service; detects theft or unauthorized movement        of equipment within the healthcare facility 33 and/or remote        therefrom (e.g., the drop packs 26 ₁ . . . 26 _(R) at the        incident scene 12).

For its part, FIG. 7B shows examples of services that can be provided bythe ECAS 30 in support of first response missions such as the firstresponse mission at the incident scene 12, in accordance with anembodiment of the invention. These “first response support” servicesinclude:

-   -   a “first responder location and tracking” service: tracks the        locations of the first responders 14 ₁ . . . 14 _(N) at the        incident scene 12;    -   a “patient location and tracking” service: tracks the locations        of the patients 18 ₁ . . . 18 _(P) at the incident scene 12;    -   an “equipment tracking and/or monitoring” service: tracks the        locations and/or monitors the conditions of equipment (e.g.,        field medical equipment and the drop packs 26 ₁ . . . 26 _(R))        at the incident scene 12;    -   a “site environmental sensing” service: collects information        about environmental conditions at the incident scene 12 from the        sensor units 48, 148, 248 of the packs 22 ₁ . . . 22 _(N), 26 ₁        . . . 26 _(R), 24 ₁ . . . 24 _(P) and the sensor units 320 ₁ . .        . 320 ₉ of the ECAS outstations 28 ₁ . . . 28 _(M);    -   a “patient medical sensing” service: collects data about patient        conditions from the medical sensors of the sensor units 148        associated with the patients 18 ₁ . . . 18 _(P) at the incident        scene 12;    -   an “equipment/first responder, equipment/patient or first        responder/patient association” service: monitors associations        between the first responders 14 ₁ . . . 14 _(N), the patients 18        ₁ . . . 18 _(P) and equipment (e.g., the packs 22 ₁ . . . 22        _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)) at the incident        scene 12;    -   a “site environmental sensing association and tracking” service:        observes data from the various sensing planes of the sensor        units 48, 148, 248 of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . .        26 _(R), 24 ₁ . . . 24 _(P) and the sensor units 320 ₁ . . . 320        ₉ of the ECAS outstations 28 ₁ . . . 28 _(M), establishes the        profiles on those planes, and looks for inter-plane associations        that may be indicative of developing site condition issues for        the incident scene 12;    -   a “patient medical sensing association and tracking” service:        correlates and tracks data derived from each patient's medical        sensors (in its sensor unit 148) and identifies potential        conditions needing clinical/first responder notification and/or        treatment;    -   an “immobilized patient tracking and staging” service: tracks at        what stage each patient is at and maps it into required        activities such as a reserved ambulance slot for transportation;    -   a “walking patient” tracking and staging service: tracks where        the patients 18 ₁ . . . 18 _(P) are on site, when they are        mobile and may be wandering about, and maps them into        appropriate transportation away from the incident scene 12        (e.g., via ambulance or otherwise);    -   a “site equipment theft or movement outside of authorized zone”        service: ensures that equipment (e.g., the packs 22 ₁ . . . 22        _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)) at the incident        scene 12 does not “wander” without the first responders 14 ₁ . .        . 14 _(N) being aware of it (e.g., due to legitimate use by        other first responders or by theft by bystanders);    -   a “drugs and similar clinical materials (e.g. blood plasma)        theft, tampering detection plus site inventory tracking        service”: ensures that these are not stolen or tampered with so        are safe to use and can be located when need and ensures that,        if the incident scene 12 starts running short of specific        supplies (e.g., blood plasma) more can be dispatched before they        run out;    -   a “hazardous site conditions detection and response” service:        examines outputs of the site environmental tracking service and        the locations and numbers of patients and first responders and        determines whether action needs to be taken (e.g., evacuate a        specific area of the incident scene 12 first due to        deteriorating conditions in that area);    -   a “drugs and clinical materials environmental safety, security        and application tracking to casualties” service: ensures,        through monitoring with sensors drugs and clinical materials at        the incident scene 12, that these clinical supplies have not        been spoiled by exposure to a harmful environment (e.g., excess        heat) and are being used by approved personnel, and tracks which        patients they are used on so as to provide a “history on demand”        for each patient (e.g., helps to avoid problems such as two        first responders dosing patients with morphine and hence giving        them a morphine overdose);    -   a “first responder point of care/point of stabilization        communications” service: implements tools enabling the first        responders 14 ₁ . . . 14 _(N) to access information and perform        clinical tasks (e.g., decisions, stabilizing treatment and        transportation orders, etc.) at the point of first care of the        patients 18 ₁ . . . 18 _(P) at the incident scene 12;    -   a “first responder/clinician collaboration” service (and its        equivalent “first responder/first responder collaboration”        service): implements tools enabling collaboration between the        first responders 14 ₁ . . . 14 _(N) at the incident site 12 and        clinicians at the healthcare facility 33 (or between different        ones of the first responders 14 ₁ . . . 14 _(N));    -   a “first responder emergency clinical and team support” service:        invoked by a first responder when faced with a patient who is in        a critical declining condition beyond the first responder's        skills or training or when other additional help is needed with        a critical patient, forms a first response team to help from        amongst other ones of the first responders 14 ₁ . . . 14 _(N)        on-site and opens channels to high quality clinical support from        the healthcare facility 33; and    -   a “code yellow—disaster assessment and response and ongoing site        management” service: looks at all clinical activities being        performed by the first responders 14 ₁ . . . 14 _(N) and        situations of the patients 18 ₁ . . . 18 _(P) and provides a        view to the healthcare facility 33 of estimated support        resources needed as the patients 18 ₁ . . . 18 _(P) are        transported as well as helps to optimize deployment of first        response personnel at the incident scene 12; in cases where it        is clear that the first response personnel is overwhelmed, can        trigger additional resources to be called in and, as the first        response personnel complete their work, can release them and can        check (via the patient packs 24 ₁ . . . 24 _(P)) that all        patients needing transportation have been transported).

As shown in FIGS. 7A and 7B, these and other services that can beprovided by the ECAS 30 can be categorized into four distinct layers,namely a “basic environmental services” layer 611, an “associative andalerting environmental services” layer 613, a “non-clinical and clinicalsupport services” layer 615, and a “clinical services” layer 617. Eachof these service layers can have specific constraints and requirements.For instance, services in the clinical services layer 617 services canbe subject to intense scrutiny (e.g., under the Health InsurancePortability and Accountability Act (HIPAA)) to ensure patientinformation safety and confidentiality is maintained.

In order to provide these services, the processing entity 420 of theECAS 30 comprises suitable hardware and software (which may includefirmware) for implementing a plurality of functional components, which,in this embodiment, include an environmental data processing engine 411,a situational context processing engine 421, an institutional contextprocessing engine 431 and a decision making engine 441. Examples of suchprocessing engines and their functionality, particularly in respect ofthe services provided in a healthcare facility such as the healthcarefacility 33, can be obtained by consulting U.S. patent application Ser.No. 12/003,206 referenced previously herein.

Considering specifically the first response support servicescontemplated herein, and taking as an example the first response missionat the incident scene 12, the environmental data processing engine 411processes data transmitted by the ECAS outstations 28 ₁ . . . 28 _(M)and received via the wireless outstation interface 400, such as datarelated to times of arrival of wireless location signals transmitted bythe packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P),data generated by the sensor units 48, 148, 248 of these packs, datagenerated by the sensor units 320 ₁ . . . 320 ₉ of these ECASoutstations, and/or data derived from input made by the first responders14 ₁ . . . 14 _(N) via the user interface 52 of their first responderpacks, in order to derive data indicative of an “environment” at theincident scene 12. This environment can be viewed as an aggregation ofpeople, objects, conditions, and influences present at the incidentscene 12. It can be observed along a plurality of environment planes,such as a location plane which considers locations of people and objectsat the incident scene 12, a physical environment plane which considersheat/temperature, humidity, light, radiation, presence of specific gasesor compounds, physical states such as door openings and other physicalaspects of the environment at the incident scene 12, and a physiologicalplane which considers physiological/medical conditions of patients atthe incident scene 12. Thus, the data indicative of the environment atthe incident scene 12 that is derived by the environmental dataprocessing engine 411 comprises data indicative of various aspects ofthe environment, such as: locations of the first responders 14 ₁ . . .14 _(N), the patients 18 ₁ . . . 18 _(P), and the drop packs 26 ₁ . . .26 _(R) at the incident scene 12; physical parameters such astemperature, pressure, chemical concentration, radiation level, etc., atthe incident scene 12; and physiological parameters such as heart rate,body temperature, etc., of the patients 18 ₁ . . . 18 _(P) at theincident scene 12.

The situational context processing engine 421 processes the dataindicative of the environment at the incident scene 12 to compare,correlate or otherwise consider different aspects of the environment(e.g., locational, physical, physiological aspects) and determine thatone or more “situations” have occurred in relation to the first responsemission at the incident scene 12. Each of these one or more situationsis a set of circumstances surrounding an event or group of events, aprevious history of that event/those events and any associated factors.Collectively, the one or more situations can be viewed as a “situationalcontext” of the first response mission at the incident scene 12.

For example, the situational context processing engine 421 may: comparethe locations of the first responders 14 ₁ . . . 14 _(N), the patients18 ₁ . . . 18 _(P), and the drop packs 26 ₁ . . . 26 _(R) amongst oneanother (e.g., to detect that a first responder 14 _(i) is next to apatient 18 _(i) and infer from this proximity that the first responder14 _(i) is treating the patient 18 _(i)); track physical parameterssensed by the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . .24 _(P) over time (e.g., to detect a sudden increase in temperaturearound one of these packs or detect that a hazardous contaminant isspreading in a specific area at the incident scene 12); comparephysiological parameters of the patients 18 ₁ . . . 18 _(P) sensed bytheir packs 24 ₁ . . . 24 _(P) at different times (e.g., to detect asignificant drop in vital signs of a patient 18 _(j)); etc.

In determining the one or more situations deemed to have occurred, thesituational context processing engine 421 may also process data otherthan the data indicative of the environment at the incident scene 12.For example, the situational context processing engine 421 may processdata derived from the communication system 208 of the healthcarefacility 33, such as data relating to communications made the firstresponders 14 ₁ . . . 14 _(N) using their packs 14 ₁ . . . 14 _(N)(e.g., reports about patients or conditions at the incident scene 12)and/or data relating to communications (e.g., telephonic communications,pages, sessions at computer terminals) involving clinicians at thehealthcare facility 33. As another example, the situational contextprocessing engine 421 may process data indicative of an environment atthe healthcare facility 33 and derived by the environmental dataprocessing engine 411, such as locations of clinicians and/or equipmentwithin the healthcare facility 33.

Examples of situations that can be deemed to have occurred in relationto the first response mission are presented below. For now, suffice itto say that the situational context processing engine 421 outputs dataindicative of the one or more situations deemed to have occurred, i.e.,data indicative of the situational context of the first responsemission.

The institutional context processing engine 431 consults theinstitutional information system 200 based on the data indicative of theone or more situations deemed to have occurred in order to provide tothe decision making engine 441 institutional data relevant to these oneor more situations. The institutional data can be viewed as dataindicative of an “institutional context” that specifies, for example,what is allowable (e.g., policies), what resources are available (e.g.,people, skills, duty roster, equipment list), what should normallyhappen (e.g., history) and/or how to proceed (e.g., procedures, rules,guidelines) in respect of the one or more situations. Examples ofinstitutional data that can be provided by the institutional contextprocessing engine 431 are presented below

Based on the data indicative of the one or more situations deemed tohave occurred (provided by the situational context processing engine421) and the institutional data relevant to these one or more situations(provided by the institutional context processing engine 431), thedecision making engine 441 determines one or more actions to be takenwith respect to the first response mission in order to address these oneor more situations.

For example, the decision making engine 441 may determine that one ormore communication actions are to be taken to address the one or moresituations, such as transmitting one or more messages to the firstresponders 14 ₁ . . . 14 _(N) at the incident scene 12 and/or cliniciansat the healthcare facility 33, establishing a communication link betweena first responder at the incident scene 12 and a clinician at thehealthcare facility 33, etc. The decision making engine 441 can thencommand the communication system 208 to perform the one or morecommunication actions that are to be taken (e.g., send commands to thecommunication system 208 to transmit messages to the first responders 14₁ . . . 14 _(N), establish a communication link between a firstresponder at the incident scene 12 and a clinician at the healthcarefacility 33, etc.).

Thus, by virtue of its processing engines 411, 421, 431, the processingentity 420 of the ECAS 30 has both an environmental awareness and acontextual awareness that enables it to make relevant decisions andcause actions to be taken based on these decisions. This can be seenfrom FIG. 8, which provides a high level view of an “environmentalawareness” component 501 and a “contextual awareness and response”component 503 of the processing entity 420 of the ECAS 30.

The environmental awareness component 501, which can be implemented bythe environmental data processing engine 411, enables a comprehensiveunderstanding of the environment in which a person or object is, bycollecting data from various sensors and other devices (e.g., the packs22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P)), bringingthis data to a point where data reduction can be applied, whereby it canbe logically mapped and correlated and expert system primitives can bederived allowing the detection of various conditions (e.g. proximity ofa first responder with his/her assigned patient) and data useful to thesituational context processing engine 421 can be formulated. Bycollecting, aggregating, fusing, and virtualizing this information, amuch deeper understanding can be created. This heightened environmentalawareness is beneficial on its own merits as an independent functionalblock for use by other functional blocks and applications. It can alsobe useful to integrate the result of the environmental awarenesscomponent 501 into the contextual awareness and response component 503.

Specifically, the contextual awareness and response component 503 hastwo parts, namely a situational part 505, which can be implemented bythe situational context processing engine 421, and an institutional part507, which can be implemented by the institutional context processingengine 431. As mentioned above, situational context can be viewed as oneor more situations deemed to have occurred in substantially real time,while institutional context can be viewed as the context of what theinstitution's or facility's policies, procedures and the like wouldindicate ought to be happening. As a whole, the contextual awareness andresponse component 503 takes raw information, databases, environmentalawareness information and other types of “inputs” and melds this intosituationally appropriate awareness and responses. To this end, thecontextual awareness and response component 503 may implement contextualfusion (such as synthesis, artificial intelligence, spatial, temporal,multi-dimensional and customized fusion) based on contextual enablers(such as analytics, modeling, personalization, workflow, ontology,identity and inferential engines).

The combination of both environmental awareness (i.e., the environmentaldata processing engine 411) and contextual awareness and response (i.e.,the situational context processing engine 421 and the institutionalcontext processing engine 431), enables a comprehensive understanding ofconditions and provides the ability to leverage that understanding tomake decisions and take actions by a wide range of workflow andsupporting IT systems, applications, and end users or their clients.

The environmental data processing engine 411, the situational contextprocessing engine 421, the institutional context processing engine 431and the decision making engine 441 may comprise one or more processorsto perform their processing operations. A given one of these one or moreprocessors may be a general-purpose processor having access to a storagemedium (e.g., semiconductor memory, including one or more ROM and/or RAMmemory devices) storing program code for execution by that processor toimplement the relevant processing operations. Alternatively, a given oneof these one or more processors may be a specific-purpose processorcomprising one or more pre-programmed hardware or firmware elements(e.g., ASICs, EEPROMs, etc.) or other related elements to implement therelevant processing operations.

To illustrate how the environmental data processing engine 411, thesituational context processing engine 421, the institutional contextprocessing engine 431 and the decision making engine 441 can provide thefirst response support services contemplated herein, various examples ofsituations which can arise will now be considered.

Example 1

By processing the data indicative of the environment at the incidentscene 12 (i.e., location data, physical data, physiological data)produced by the environmental data processing engine 411, thesituational context processing engine 421 determines that the followingsituation has occurred: vital signs of a patient 18 _(x) have droppedsignificantly (based on physiological data from the patient pack 24 _(x)of the patient 18 _(x)); none of the first responders 14 ₁ . . . 14 _(N)is currently treating the patient 18 _(x) (based on their location); afirst responder 14 _(k) who initially treated the patient 18 _(x) is nowfar away and treating another patient (based on their location and/orother determinants of the situational context, such as communicationsinvolving the first responder 14 _(k) or a state of that other patient'spatient pack); a first responder 14 _(y) is close to the patient 18 _(x)(based on their location); and the first responder 14 _(y) is notcurrently treating any of the patients 18 ₁ . . . 18 _(P) (based ontheir location and/or other determinants of the situational context,such as communications involving the first responder 14 _(y) or a lackof any current association between the first responder 14 _(y) and anyof the patients).

Based on the data indicative of this situation, the institutionalcontext processing engine 431 consults the institutional informationsystem 200 to obtain institutional data relevant to this situation. Forinstance, the institutional data may include: data indicating thatimmediate treatment needs to be administered to the patient 18 _(x)(based on his/her vitals signs); data describing the required treatment;and data defining a skill set of the first responder 14 _(y) (based onhis/her identity).

The decision making engine 441 determines, on a basis of the dataindicative of the situation and the institutional data relevant to thesituation, that a message is to be sent to the first responder 14 _(y)to indicate that the patient 18 _(x) needs immediate treatment, conveythe location of the patient 18 _(x) (and/or directions thereto), andconvey information on the required treatment to be administered. Thedecision making engine 441 causes the message to be transmitted to thefirst responder pack 22 _(y) of the first responder 14 _(y), via thecommunication system 208 and/or the wireless outstation interface 400.

In some cases, depending upon policies of the healthcare facility 33, acertain level of preference to have the first responder 14 _(k) whoinitially treated the patient 18 _(x) return or notified of actionsperformed by the first responder 14 _(y) may be invoked for continuityof care reasons (e.g., to avoid “double dose of morphine” or otherproblems from uncoordinated treatments). This may also be managedthrough a medical file associated with the patient 18 _(x), which may bemade available to the first responder 14 _(k) or any other authorizedfirst responder approaching into a proximate relationship with thepatient 18 _(x) after being treated by the first responder 14 _(y).

Example 2

By processing the data indicative of the environment at the incidentscene 12 produced by the environmental data processing engine 411 and byprocessing data relating to communications effected via thecommunication system 208, the situational context processing engine 421determines that the following situation has occurred: a patient 18 _(y)is currently being treated by a first responder 14 _(z) (based on theirlocation); and the first responder 14 _(z) has requested treatmentinformation for the patient 18 _(y) using his/her first responder pack22 _(z), for example, by describing a physical condition or symptoms ofthe patient 18 _(y) and requesting assistance from a doctor to determinewhat treatment to give.

Based on the data indicative of this situation, the institutionalcontext processing engine 431 consults the institutional informationsystem 200 to obtain institutional data relevant to this situation. Forinstance, the institutional data may include: data indicative that Dr.Smith is available (based on his schedule and communication status) andqualified (based on his skill set) to provide assistance to the firstresponder 14 _(z).

The decision making engine 441 determines, on a basis of the dataindicative of the situation and the institutional data relevant to thesituation, that a message is to be sent to Dr. Smith to request hisassistance and put him in contact with the first responder 14 _(z) atthe incident scene 12 to determine what treatment to give to the patient18 _(y).

The decision making engine 441 causes the message to be transmitted toDr. Smith via the communication system 208. If and when Dr. Smith isreached, the decision making engine 441 may cause a communication linkto be established between Dr. Smith and the first responder 14 _(z) viathe communication system 208 and the first responder pack 22 _(z) of thefirst responder 14 _(z). In some cases, this communication link mayenable filtered shared viewing of information concerning the patient 18_(y) such as the on-site treatment records to date, vital signs andother physiological data history or the patient's HER, if available.

Example 3

By processing the data indicative of the environment at the incidentscene 12 produced by the environmental data processing engine 411 (andpossibly by processing data relating to communications effected via thecommunication system 208), the situational context processing engine 421determines that the following situation has occurred: twenty patients 18₁ . . . 18 ₂₀ at the incident scene 12 have low vital signs (based onphysiological data from their patient packs 24 ₁ . . . 24 ₂₀ andpossibly based on reports provided by the first responders 14 ₁ . . . 14_(N) using their first responder packs 22 ₁ . . . 22 _(N)).

Based on the data indicative of this situation, the institutionalcontext processing engine 431 consults the institutional informationsystem 200 to obtain institutional data relevant to this situation. Forinstance, the institutional data may include: data indicative thatseventeen of the patients 24 ₁ . . . 24 ₂₀ need immediate transportationto an ER (based on their vital signs); data indicative that the ER ofthe healthcare facility 33 currently has a capacity to handle a maximumof ten additional patients (based on the current number of admittedpatients and the available resources, such as doctors and nurses); anddata indicative of another nearby healthcare facility to which patientsmay be transported.

The decision making engine 441 determines, on a basis of the dataindicative of the situation and the institutional data relevant to thesituation, that messages are to be sent to the first responders 14 ₁ . .. 14 _(N) to indicate that ten of the patients 18 ₁ . . . 18 ₂₀ who needimmediate transportation are to be immediately transported to the ER ofthe healthcare facility 33 and that the other seven of these patientswho need immediate transportation are to be transported to the othernearby healthcare facility. The decision making engine 441 causes themessages to be transmitted to the first responder packs 22 ₁ . . . 22_(N) of the first responders 14 ₁ . . . 14 _(N), via the communicationsystem 208 and/or the wireless outstation interface 400.

Example 4

By processing the data indicative of the environment at the incidentscene 12 produced by the environmental data processing engine 411, thesituational context processing engine 421 determines that the followingsituation has occurred: concentration of a toxic gas (e.g., carbonmonoxide) has increased significantly in a particular area at theincident scene 12 (based on physical data and location data from one ormore of the drop packs 26 ₁ . . . 26 _(R)); a first responder 14 _(x)and a patient 18 _(z) are located in that particular area (based ontheir location); no toxic gas has been sensed in other areas at theincident scene 12 (based on physical data and location data from one ormore of the packs 26 ₁ . . . 26 _(R), 22 ₁ . . . 22 _(N), 24 ₁ . . . 24_(P)).

Based on the data indicative of this situation, the institutionalcontext processing engine 431 consults the institutional informationsystem 200 to obtain institutional data relevant to this situation. Forinstance, the institutional data may include data indicating thatimmediate evacuation from the given area is required (based on theconcentration of the toxic gas).

The decision making engine 441 determines, on a basis of the dataindicative of the situation and the institutional data relevant to thesituation, that a message is to be sent to the first responder 14 _(x)to indicate that he/she and the patient 18 _(z) need to immediately moveaway from their current location and convey the location of the nearestsafe area (and/or directions thereto). The decision making engine 441causes the message to be transmitted to the first responder pack 22 _(x)of the first responder 14 _(x), via the communication system 208 and/orthe wireless outstation interface 400.

Example 5

By processing the data indicative of the environment at the incidentscene 12 produced by the environmental data processing engine 411, thesituational context processing engine 421 determines that the followingsituation has occurred: hazardous conditions (e.g., fire, toxic gas,intense structural vibrations) exist in a given area at the incidentscene 12 (based on physical data and location data from one or more ofthe packs 26 ₁ . . . 26 _(R), 22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P));two first responders 14 _(y) and 14 _(z) and a patient 18 _(z) they arecarrying are moving on a path that passes through that given area (basedon their location and movement direction); no hazardous conditions havebeen sensed in other areas at the incident scene 12 (based on physicaldata and location data from one or more of the packs 26 ₁ . . . 26 _(R),22 ₁ . . . 22 _(N), 24 ₁ . . . 24 _(P)). In some embodiments, knowledgeof the hazardous conditions in the given area at the incident scene 12and of the lack of such hazardous conditions in the other areas at theincident 12 may be derived from pre-existing data sources (e.g.,sensors, information systems) available at the incident scene 12 and towhich the ECAS outstations 28 ₁ . . . 28 _(M) may be connected.

Based on the data indicative of this situation, the institutionalcontext processing engine 431 consults the institutional informationsystem 200 to obtain institutional data relevant to this situation. Forinstance, the institutional data may include data indicating thatimmediate evacuation from the given area is required (based on thedetected hazardous conditions).

The decision making engine 441 determines, on a basis of the dataindicative of the situation and the institutional data relevant to thesituation, that a message is to be sent to the first responders 14 _(y)and 14 _(z) to indicate that they are to take an alternate path and toconvey directions describing this alternate path. The decision makingengine 441 causes the message to be transmitted to the first responderpacks 22 _(y) and 22 _(z) of the first responders 14 _(y) and 14 _(z),via the communication system 208 and/or the wireless outstationinterface 400.

These examples of situations which can arise and actions that can betaken are presented for illustrative purposes only as various othersituations can arise and may be addressed by the ECAS 30.

It will thus be appreciated that the first response support system 10facilitates the first response mission at the incident scene 12 in thatit provides the first responders 14 ₁ . . . 14 _(N) with bidirectionalcommunication capability, real-time support for their information needs,and knowledge about their environment as they stabilize and transportthe patients 18 ₁ . . . 18 _(P) under what may be hazardous conditions.By acting on automated decisions based on data on the location and stateof the patients 18 ₁ . . . 18 _(P) and the first responders 14 ₁ . . .14 _(N) and their equipment, the efficiency of first response missioncan be improved.

For example:

-   -   Data about the patients 18 ₁ . . . 18 _(P) may be uploaded to        the healthcare facility 33 (and/or one or more other receiving        healthcare facilities) and data to support their treatment and        transportation may be downloaded to the first responder packs 14        ₁ . . . 14 _(N). Vital signs of the patients 18 ₁ . . . 18 _(P)        may be monitored and tracked/analyzed while they are being        prepared for transportation and during transportation.    -   Locations of the first responders 14 ₁ . . . 14 _(N) and the        patients 18 ₁ . . . 18 _(P), as well as evolution of hazardous        conditions at the incident scene 12, may be tracked and alerts        may be sent to the first responders as the environment at the        incident scene 12 changes.    -   Clinical workflows of the first responders 14 ₁ . . . 14 _(N)        can be integrated with workflows of the healthcare facility 33,        allowing its ER (or other receiving department) to prepare for        incoming ones of the patients 18 ₁ . . . 18 _(P). Specifically,        the healthcare facility 33 receives information indicative of        the number, type and condition of the patients 18 ₁ . . . 18        _(P), both from the first responders 14 ₁ . . . 14 _(N) who        provide assessments and/or communicates with clinicians using        their first responder packs 22 ₁ . . . 22 _(N) and from the ECAS        30 which analyzes the ongoing dynamic, monitoring the location,        vital condition, environmental conditions of each patient,        allowing the ECAS 30 to build up a patient record, combine this        with any previous EPR, EMR, EHR, flag issues (e.g. allergies) to        the first responder and the general clinical team and to take        various actions as-needed based on multiple factors including        clinician skills and availability, first responder skills,        availability and proximity to the patient, etc. according to        policies, procedures appropriate to the deemed situation as well        as flag other threats to the patient before or during        transportation.    -   The ECAS 30 can monitor a patient 18 _(j) and, based upon        his/her dynamic patient clinical condition, may instruct actions        to be carried out, such as immediate or more urgent        transportation of the patient 18 _(j), may request activity of a        first responder 14 _(j) on the patient 18 _(j) and/or may        present its findings to a hospital clinician to trigger these        events or may put the clinician in contact with the first        responder 14 _(j), or may forward the patient information to an        appropriate clinician for their determination of a course of        action, based upon hospital policies and procedures.    -   Based upon the collected data, the ECAS 30 can communicate with        an appropriate clinician on a basis of factors such as skills,        availability/current and planned workload, duty roster,        assignment (e.g. to ER), and can establish communications        between the clinician and one or more of the first responders 14        ₁ . . . 14 _(N), especially the first responder who is with or        nearest to a particular patient whose treatment requires        information from the clinician.

Assessments of the number, condition, and likely level of treatment ofthe patients 18 ₁ . . . 18 _(P) can be made to route those patients whorequire further treatment to the healthcare facility 33 and/or one ormore other receiving healthcare facilities which is/are best suited,allowing load leveling across the ERs of multiple hospitals and allowingthe entire ER resources of multiple hospitals to be brought to bearwithout ending up with too many cases at one ER, while another one isunder-loaded.

-   -   Verbal assessments about the incident scene 12 made by the first        responders 14 ₁ . . . 14 _(N) may not only be communicated to        personnel at the healthcare facility 33, but may also be        integrated with other data generated by the packs 22 ₁ . . . 22        _(N), 24 ₁ . . . 24 _(P), 26 ₁ . . . 26 _(R). For instance, in        some embodiments, the communication system 208 of the healthcare        facility 33 may implement speech processing unit that can parse        a verbal assessment made by a first responder 14 _(j) using the        communication unit 59 of his/her first responder pack 22 _(j) to        identify relevant items of information contained in the first        responder's verbal assessment and provide data conveying this        information to the ECAS 30 (e.g., to the environmental data        processing engine 411 or the situational context processing        engine 421). For example, the first responder 14 _(j) arrives at        the incident scene 12 and realizes that multiple people are        injured. The first responder 14 _(j) can very quickly recognize        and diagnose (at a certain level) various medical related        attributes of an injured person and verbally express his/her        assessment (e.g., “Medical emergency. Victim female, no        identification, Jane Doe, age ˜25-30, second degree burns on        left arm and leg. Possible fractured left leg. Heavy bleeding        above right eye. Collecting pulse and BP from sensor pack”),        which is processed by the speech processing unit that parses the        verbal assessment, identifies relevant items of information        contained therein, assigns meta-tags, and send the resulting        data to the ECAS 30 where it is integrated with all other        appropriate sensor/context information associated with that        person's condition.

While these examples illustrate certain benefits that can be provided bythe first response support system 10, it will be appreciated thatvarious other benefits may arise from use of the first response supportsystem 10.

Cascaded Location Process

As mentioned above, in this embodiment, the processing system 20implements the cascaded location process to extend itslocation-awareness capability across the incident scene 12. Generally,with the cascaded location process, the processing system 20 determinesthe locations of the first responder packs 22 ₁ . . . 22 _(N), the droppacks 26 ₁ . . . 26 _(R), and the patient packs 24 ₁ . . . 24 _(P) inmultiple stages, whereby located ones of these packs are used to receivewireless location signals from unlocated ones of these packs andtransmit wireless signals to the processing system 20 on a basis of thewireless location signals that they receive in order to enable thelocations of the unlocated packs to be determined.

The cascaded location process will now be further discussed withreference to FIGS. 9A to 9E, in an example scenario where three vehicles16 _(x), 16 _(y), 16 _(z) transporting three ECAS outstations 28 _(x),28 _(y), 28 _(z) arrive at the incident scene 12.

A location of each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) isdetermined by the ECAS 30 using the outstation location unit 310 ofthese outstations. More particularly, in this embodiment, the GPSreceiver of the outstation location unit 310 of each of the ECASoutstations 28 _(x), 28 _(y), 28 _(z) allows each of these outstationsto transmit location data indicative of its location to the ECAS 30 viaits wireless ECAS interface 340.

Each of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) extends itsextensible arms 307 ₁ . . . 307 ₅ on which are disposed its packlocation units 302 ₁ . . . 302 ₅. Locations of the pack location units302 ₁ . . . 302 ₅ of each of the ECAS outstations 28 _(x), 28 _(y), 28_(z) are determined by the processing system 20. In this embodiment, theprocessing system 20 determines the location of each of the packlocation units 302 ₁ . . . 302 ₅ of each of the ECAS outstations 28_(x), 28 _(y), 28 _(z) based on times of arrival of a wireless locationsignal transmitted by its location transmitter 306 at three or more ofthe location receivers 303 of the pack location units 302 ₆ . . . 302 ₉(fixed at known locations) of that ECAS outstation (or otherwise, suchas based on engineering and other information regarding the extensiblearms 307 ₁ . . . 307 ₅, such as their actual extension length andorientation). Once located, the pack location units 302 ₁ . . . 302 ₅ ofeach of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) have theirlocation receivers 303 activated.

The location receivers 303 of the ECAS outstations 28 _(x), 28 _(y), 28_(z) create respective “primary” coverage areas A1 _(x), A1 _(y), A1_(z) of these outstations. The primary coverage area A1 _(x) refers toan area in which each point is within the respective ranges of at leastthree location receivers 303 of the ECAS outstation 28 _(x), therebyallowing a location transmitter in that area to be located throughapplication of triangulation techniques based on a wireless locationsignal transmitted by that location transmitter and received at theselocation receivers. The primary coverage areas A1 _(y) and A1 _(z) ofthe ECAS outstations 28 _(y) and 28 _(z) are similarly defined.

In addition, the location receivers 303 of the ECAS outstations 28 _(x),28 _(y), 28 _(z) create respective “secondary” coverage areas A2 _(x),A2 _(y), A2 _(z) and respective “tertiary” coverage areas A3 _(x), A3_(y), A3 _(z) of these outstations. The secondary coverage area A2 _(x)refers to an area in which each point is within the respective ranges ofonly two location receivers 303 of the ECAS outstation 28 _(x), whilethe tertiary coverage area A3 _(x) refers to an area in which each pointis within the range of only one location receiver 303 of the ECASoutstation 28 _(x). The secondary coverage areas A2 _(y) and A2 _(z) andthe tertiary coverage areas A3 _(y) and A3 _(z) of the ECAS outstations28 _(y) and 28 _(z) are similarly defined. While a location transmitterlocated in only one of the secondary coverage areas A2 _(x), A2 _(y), A2_(z) and tertiary coverage areas A3 _(x), A3 _(y), A3 _(z) cannot belocated by the processing system 20, a location transmitter located in aregion where two or more of these secondary and tertiary coverage areasoverlap may be locatable by the processing system 20. In other words, alocation transmitter lying outside the primary coverage areas A1 _(x),A1 _(y), A1 _(z) of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) andtransmitting a wireless location signal can be located by the processingsystem 20 when this wireless location signal is received by three ormore location receivers 303 distributed among two or all three of theECAS outstations 28 _(x), 28 _(y), 28 _(z).

While they are shown as circles for simplicity, the coverage areas A1_(x), A1 _(y), A1 _(z), A2 _(x), A2 _(y), A2 _(z), A3 _(x), A3 _(y), A3_(z) will typically have more complex configurations depending on thenumber, relative positions and nature (e.g., omnidirectional ordirectional, range, etc.) of the location receivers 303 of the ECASoutstations 28 _(x), 28 _(y), 28 _(z) and possibly other factors (e.g.,signal path impairments and/or blockages, etc.).

Meanwhile, some of the first responders 14 ₁ . . . 14 _(N) who arrivedon the vehicles 16 _(x), 16 _(y), 16 _(z) are deployed, carrying withthem some of the first responder packs 22 ₁ . . . 22 _(N) as well assome of the patient packs 24 ₁ . . . 24 _(P) and some of the drop packs26 ₁ . . . 26 _(R). For purposes of this example, it is assumed that, ata particular moment, these packs, which are denoted 51 ₁ . . . 51 ₁₂(where each pack 51 _(j) is one of the packs 22 ₁ . . . 22 _(N), 24 ₁ .. . 24 _(P), 26 ₁ . . . 26 _(R)), are distributed at the incident scene12 as shown in FIG. 9A.

First Stage

The packs 51 ₁, 51 ₄, 51 ₆, 51 ₉ are located in the primary coverageareas A1 _(x), A1 _(y), A1 _(z) of the ECAS outstations 28 _(x), 28_(y), 28 _(z) and are thus locatable. For example, the locationtransmitter 41, 141, 241 of the pack 51 ₁ transmits a wireless locationsignal L₁ that is received by three or more location receivers 303 ofthe ECAS outstation 28 _(x). Based on the wireless location signal L₁,the processing system 20 proceeds to determine a location of the pack 51₁.

More particularly, in this embodiment, the processing entity 360 of theECAS outstation 28 _(x) transmits data derived from the wirelesslocation signal L₁ to the ECAS 30 via its wireless ECAS interface 340.In this case, the data derived from the wireless location signal L₁comprises data relating to times of arrival of that signal at the threeor more location receivers 303 of the ECAS outstation 28 _(x). Also, inthis case, the data derived from the wireless location signal L₁comprises identification data conveyed by that signal and provided bythe identification unit 46, 146, 246 of the pack 51 ₁.

Upon receiving the data derived from the wireless location signal L₁ viathe wireless outstation interface 400, and with knowledge of thelocation of the ECAS outstation 28 _(x), the processing entity 420 ofthe ECAS 30 determines the location of the pack 51 ₁ based on this data.More particularly, in this embodiment, the environmental data processingengine 411 implements a location determination unit 432 that determinesthe location of the pack 51 ₁ based on the data relating to the times ofarrival of the wireless location signal L₁ at the three or more locationreceivers 303 of the ECAS outstation 28 _(x). The location determinationunit 432 can employ any suitable triangulation technique (or any othersuitable location determination technique or range and directiondetermination technique).

For example, FIGS. 10A to 10D show an example of a geometry associatedwith a location determination process based on a differential time ofarrival solution. Considering FIG. 10A, this shows a case where threelocation receivers R1, R2, and R3 (which can be any three locationreceivers 303 of the ECAS outstation 28 _(x)) receive the wirelesslocation signal L₁ transmitted by the pack 51 ₁ and where the locationreceivers R1 and R2 have cooperated to determine that R1 received thesignal L₁ at time +2 relative to when R2 received the signal L₁. Thus,the time of flight of the signal L₁ to the location receiver R1 islonger by a factor of the time difference multiplied by the propagationvelocity, which in this case is the speed of light. The locus or curveof locations which can meet this criterion can be plotted, as shown as“+2 time difference” in FIG. 10A. Other time differences result in otherlocus curves but the pack 51 ₁ could be located anywhere along thatcurve. FIG. 10B shows the complete set of locus curves for the locationreceivers R1 and R2. FIG. 10C overlays the R1-R2 locus curves with thelocus curves developed by comparing the time of reception of the signalL₁ at location receivers R3 and R2. While the locus curves are similarin structure to the locus curves of R1 and R2 they are developed arounda different baseline, that of R2 to R3, and so do not coincide with theR1-R2 locus curves Hence, by combining these measurements the actuallocation can be narrowed down to one or sometimes two locations.Repeating this with the third available baseline, R1 to R3, allows theambiguity to be resolved as is shown in FIG. 10D. As is also shown inthese figures, the system becomes less precise at greater distances dueto the reduced subtended angle between the source and the receiverbaselines. This can be improved by increasing the receiver baselines,either by extending the arms 307 ₁ . . . 307 ₅ of the first responsevehicle 16 _(x) or, once the baseline between various vehicles and/orlocated packs is determined, using those as a long baseline measuringcapability. While this example illustrates one type of locationdetermination process, various other location determination processesmay be used in other examples

The environmental data processing engine 411 thus obtains dataindicative of the location of the pack 51 ₁ from its locationdetermination unit 432. In other embodiments, the location determinationunit 432 may be distinct from but connected to the environmental dataprocessing engine 411 to which it may feed the data indicative of thelocation of the pack 51 ₁ when generated.

In a similar manner, the processing system 20 proceeds to determine alocation of each of the packs 51 ₄, 51 ₆, 51 ₉ based on wirelesslocation signals L₄, L₆, L₉ transmitted by these packs and received bythree or more location receivers 303 of the ECAS outstation 28 _(y), 28_(z).

The packs 51 ₅, 51 ₇ are located in a region where the secondarycoverage area A2 _(y) of the ECAS outstation 28 _(y) and the tertiarycoverage area A3 _(z) of the ECAS outstation 28 _(z) overlap, and arethus also locatable. For example, the location transmitter 41, 141, 241of the pack 51 ₅ transmits a wireless location signal L₅ that isreceived by only two location receivers 303 of the ECAS outstation 28_(y), but that is also received by a single one of the locationreceivers 303 of the ECAS outstation 28 _(z). Based on the wirelesslocation signal L₅, the processing system 20 proceeds to determine alocation of the pack 51 ₅.

More particularly, the processing entity 360 of the ECAS outstation 28_(y) transmits data derived from the wireless location signal L₅ to theECAS 30 via its wireless ECAS interface 340, where this data comprisesdata relating to times of arrival of that signal at the two locationreceivers 303 of the ECAS outstation 28 _(y) as well as identificationdata conveyed by that signal and provided by the identification unit 46,146, 246 of the pack 51 ₅. Similarly, the processing entity 360 of theECAS outstation 28 _(z) transmits data derived from the wirelesslocation signal L₅ to the ECAS 30 via its wireless ECAS interface 340,where this data comprises data relating to a time of arrival of thatsignal at the single one of the location receivers 303 of the ECASoutstation 28 _(z) as well as identification data conveyed by thatsignal and provided by the identification unit 46, 146, 246 of the pack51 ₅.

Upon receiving the data derived from the wireless location signal L₅from the ECAS outstations 28 _(y), 28 _(z) via the wireless outstationinterface 400, and with knowledge of the location of each of the ECASoutstations 28 _(y), 28 _(z), the processing entity 420 of the ECAS 30determines the location of the pack 51 ₅ based on this data. Moreparticularly, the location determination unit 432 implemented by theenvironmental data processing engine 411 determines the location of thepack 51 ₅ based on the data relating to the times of arrival of thewireless location signal L₅ at the two location receivers 303 of theECAS outstation 28 _(y) and at the single one of the location receivers303 of the ECAS outstation 28 _(z). The environmental data processingengine 411 thus obtains data indicative of the location of the pack 51₅.

In a similar manner, the processing system 20 proceeds to determine alocation of the pack 51 ₇ based on a wireless location signal L₇transmitted by that pack and received by only two location receivers 303of the ECAS outstation 28 _(y) but also received by a single one of thelocation receivers 303 of the ECAS outstation 28 _(z).

Second Stage

Having determined the locations of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51₇, 51 ₉, the processing system 20 may use these known locations todetermine the locations of other ones of the packs 51 ₁ . . . 51 ₁₂.

Specifically, the ECAS outstation 28 _(x), 28 _(y), 28 _(z) sendwireless signals to the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉conveying commands to activate their location receiver 43, 143, 243 inorder to receive wireless location signals from other ones of the packs51 ₁ . . . 51 ₁₂ that might be within their range. As shown in FIG. 9B,the location receivers 43, 143, 243 of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆,51 ₇, 51 ₉ have respective ranges that create respective coverage areasP₁, P₄, P₅, P₆, P₇, P₉, whereby a wireless signal transmitted by alocation transmitter within the coverage area P₁ is received by the pack51 ₁, a wireless signal transmitted by a location transmitter within thepack coverage area P₂ is received by the pack 51 ₂, and so on. Whilethey are shown as circles for simplicity, the coverage areas P₁, P₄, P₅,P₆, P₇, P₉ may have more complex configurations depending on the nature(e.g., omnidirectional or directional, range, etc.) of the locationreceivers 43, 143, 243 of the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉and possibly other factors (e.g., signal path impairments and/orblockages, etc.).

The coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉ of the packs 51 ₁, 51 ₄, 51₅, 51 ₆, 51 ₇, 51 ₉ can be combined with one or more of the secondarycoverage areas A2 _(z), A2 _(y), A2 _(z) and tertiary coverage areas A3_(x), A3 _(y), A3 _(z) of the ECAS outstations 28 _(x), 28 _(y), 28 _(z)in order to locate other ones of the packs 51 ₁ . . . 51 ₁₂.Specifically, a location transmitter located in a region where one ormore of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉ and one of thesecondary coverage areas A2 _(x), A2 _(y), A2 _(z) overlap or in aregion where one or more of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉and two of the tertiary coverage areas A3 _(x), A3 _(y), A3 _(z) overlapcan be located by the processing system 20. Also, depending ondistribution of the coverage areas P₁, P₄, P₅, 51 ₆, P₇, P₉, a locationtransmitter located in a region where three or more of the coverageareas P₁, P₄, P₅, 51 ₆, P₇, P₉ overlap can be located by the processingsystem 20. In other words, a location transmitter can be located by theprocessing system 20 when a wireless location signal that it transmitsis received by three or more location receivers 303, 43, 143, 243 thatare distributed among two or more of the ECAS outstations 28 _(x), 28_(y), 28 _(z) and the packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉.

In this case, the pack 51 ₃ is located in a region where the secondarycoverage area A2 _(z) of the ECAS outstation 28 _(z) and the coveragearea P₄ of the pack 51 ₄ overlap, the pack 51 ₈ is located in a regionwhere the tertiary coverage area A3 _(z) of the ECAS outstation 28 _(z)and the coverage areas P₆, P₇ of the packs 51 ₆, 51 ₇ overlap, and thepack 51 ₁₁ is located in a region where the secondary coverage area A2_(y) of the ECAS outstation 28 _(y) and the coverage area P₉ of the pack51 ₉ overlap. As such, the packs 51 ₃, 51 ₈, 51 ₁₁ are locatable.

For example, the location transmitter 41, 141, 241 of the pack 51 ₃transmits a wireless location signal L₃ that is received by only twolocation receivers 303 of the ECAS outstation 28 _(z), but that is alsoreceived by the location receiver 43, 143, 243 of the pack 51 ₄. Basedon the wireless location signal L₃, the processing system 20 proceeds todetermine a location of the pack 51 ₃.

More particularly, the pack 51 ₄ sends a wireless signal S₄ to the ECASoutstation 28 _(z) via its wireless interface 42, 142, 242, in responseto receipt of the wireless location signal L₃ by its location receiver43, 143, 243. The wireless signal S₄ conveys data derived from thewireless location signal L₃, i.e., data conveyed by the signal L₃ and/ordata generated upon reception of the signal L₃. In this case, the dataconveyed by the wireless signal S₄ comprises data relating to a time ofarrival of the signal L₃ at the location receiver 43, 143, 243 of thepack 51 ₄ as well as identification data conveyed by the signal L₃ andprovided by the identification unit 46, 146, 246 of the pack 51 ₃. Thewireless signal S₄ also conveys the identification data provided by theidentification unit 46, 146, 246 of the pack 51 ₄ in order to allow theECAS outstation 28 _(z) to identify the pack 51 ₄ from which it receivesthe signal S₄.

The processing entity 360 of the ECAS outstation 28 _(z) transmits dataderived from the wireless location signal L₃ to the ECAS 30 via itswireless ECAS interface 340. In this case, the data derived from thewireless location signal L₃ comprises data relating to times of arrivalof the signal L₃ at the two location receivers 303 of the ECASoutstation 28 _(z) and at the location receiver 43, 143, 243 of the pack51 ₄, as well as the identification data conveyed by the signal L₃ andprovided by the identification unit 46, 146, 246 of the pack 51 ₃. Theprocessing entity 360 of the ECAS outstation 28 _(z) also transmits tothe ECAS 30 via its wireless ECAS interface 340 the identification dataconveyed by the wireless signal S₄, which identifies the pack 51 ₄ atwhich the signal L₃ was also received.

Upon receiving the data derived from the wireless location signal L₃ andthe identification data identifying the pack 51 ₄ from the ECASoutstation 28 _(z) via the wireless outstation interface 400, and withknowledge of the location of each of the ECAS outstation 28 _(z) and thepack 51 ₄, the processing entity 420 of the ECAS 30 determines thelocation of the pack 51 ₃ based on this data. More particularly, thelocation determination unit 432 implemented by the environmental dataprocessing engine 411 determines the location of the pack 51 ₃ based onthe data relating to the times of arrival of the wireless locationsignal L₃ at the two location receivers 303 of the ECAS outstation 28_(z) and at the location receiver 43, 143, 243 of the pack 51 ₄. Theenvironmental data processing engine 411 thus obtains data indicative ofthe location of the pack 51 ₃.

In a similar manner, the processing system 20 proceeds to determine alocation of the pack 51 ₁₁ based on a wireless location signal L₁₁transmitted by that pack and received by only two location receivers 303of the ECAS outstation 28 _(y) but also received by the locationreceiver 43, 143, 243 of the pack 51 ₉, which transmits a wirelesssignal S₉ to the ECAS outstation 28 _(y) in response to receiving thesignal L₁₁. Also, the processing system 20 proceeds to determine alocation of the pack 51 ₈ based on a wireless location signal L₈transmitted by that pack and received by only one location receiver 303of the ECAS outstation 28 _(z) but also received by the locationreceivers 43, 143, 243 of the packs 51 ₆, 51 ₇, which transmit wirelesssignals S₆, S₇ to the ECAS outstations 28 _(z), 28 _(y) in response toreceiving the signal L₈.

Subsequent Stages

Having determined the locations of the packs 51 ₁, 51 ₃, 51 ₄, 51 ₅, 51₆, 51 ₇, 51 ₈, 51 ₉, 51 ₁₁, the processing system 20 may use these knownlocations to determine the locations of remaining ones of the packs 51 ₁. . . 51 ₁₂.

Specifically, as described above for the second stage, the ECASoutstation 28 _(x), 28 _(y), 28 _(z) send wireless signals to the packs51 ₃, 51 ₈, 51 ₁₁ conveying commands to activate their location receiver43, 143, 243 in order to receive wireless location signals from otherones of the packs 51 ₁ . . . 51 ₁₂ that might be within their range. Asshown in FIG. 9C, this results in creation of respective coverage areasP₃, P₈, P₁ of the packs 51 ₃, 51 ₈, 51 ₁₁, thereby further expanding theoverall coverage area. Through overlapping ones of the coverage areasP₁, P₃, P₄, P₅, P₆, P₇, P₈, P₉, P₁₁ of the packs 51 ₁, 51 ₃, 51 ₄, 51 ₅,51 ₆, 51 ₇, 51 ₈, 51 ₉, 51 ₁₁ and the secondary coverage areas A2 _(x),A2 _(y), A2 _(z) and tertiary coverage areas A3 _(x), A3 _(y), A3 _(z)of the ECAS outstations 28 _(x), 28 _(y), 28 _(z), other ones of thepacks 51 ₁ . . . 51 ₁₂ can be located by the processing system 20.Indeed, a location transmitter can be located by the processing system20 when a wireless location signal that it transmits is received bythree or more location receivers 303, 43, 143, 243 that are distributedamong two or more of the ECAS outstations 28 _(x), 28 _(y), 28 _(z) andthe packs 51 ₁, 51 ₄, 51 ₅, 51 ₆, 51 ₇, 51 ₉, 51 ₁, 51 ₃, 51 ₄, 51 ₅, 51₇, 51 ₈, 51 ₉, 51 ₁₁, in a manner similar to that described above forthe second stage.

In this case, the pack 51 ₂ is located in a region where the tertiarycoverage areas A3 _(x), A3 _(z) of the ECAS outstations 28 _(x), 28 _(z)and the coverage area P₃ of the pack 51 ₃ overlap, and the pack 51 ₁₂ islocated in a region where the tertiary coverage area A3 _(y) of the ECASoutstation 28 _(y) and the coverage areas P₁₁, P₇ of the packs 51 ₁₁, 51₇ overlap. As such, the packs 51 ₂, 51 ₁₂ are located by the processingsystem 20 based on wireless locations signals L₂, L₁₂ that theytransmit, in a manner similar to that describe above for the secondstage.

With the locations of the packs 51 ₂, 51 ₁₂ determined, the ECASoutstation 28 _(x), 28 _(y), 28 _(z) send wireless signals to thesepacks conveying commands to activate their location receiver 43, 143,243 in order to receive wireless location signals from other ones of thepacks 51 ₁ . . . 51 ₁₂ that might be within their range. As shown inFIG. 9D, this results in creation of respective coverage areas P₂, P₁₂of the packs 51 ₂, 51 ₁₂, thereby further expanding the overall coveragearea.

This latest expansion of the overall coverage area results in the pack51 ₁₀ being located in a region where the coverage areas P₇, P₈, P₁₂ ofthe packs 51 ₇, 51 ₈, P₁₂ overlap. As such, the pack 51 ₁₀ is located bythe processing system 20 based on a wireless locations signal L₁₀ thatit transmits, leading to addition of its coverage area P₁₀ to theoverall coverage area, as shown in FIG. 9E.

It will thus be appreciated that, through its multiple stages, thecascade location process enables the processing system 20 to extend itslocation-awareness capability across the incident scene 12 in anefficient manner by essentially “daisy-chaining” some of the firstresponder packs 22 ₁ . . . 22 _(N), patient packs 24 ₁ . . . 24 _(P) anddrop packs 26 ₁ . . . 26 _(R) that are deployed at the incident scene12.

In order for the cascaded location process to precisely locate the packs22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . . . 24 _(P), errorpropagation through the stages of the process should be minimized. Tothat end, and as mentioned previously, the location units 40, 140, 240of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P)and the pack location units 302 ₁ . . . 302 ₉ of the ECAS outstations 28₁ . . . 28 _(M) may employ wireless technology allowing a location ofeach of these components to be determined with an excessive level ofprecision, such as 1 m or less, to permit a build-up of tolerances in aconcatenated location approach to maintain an adequate final level ofaccuracy. For example, in this embodiment, these location units mayemploy UWB technology (e.g., UWB tags) which offers increased precision,down to tens of centimeters or less. In addition to permitting anexpanded range of applications, such as associating a pack with a personnear it, or two people together such as one of the first responders 14 ₁. . . 14 _(N) and one of the patients 18 ₁ . . . 18 _(P), the increasedaccuracy of UWB technology helps to minimize error propagation throughthe stages of the cascaded location process.

While each of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . .. 24 _(P) may normally be located when a wireless location signal thatit transmits is received by at least three location receivers 303, 43,143, 243 that are distributed among two or more of the ECAS outstations28 _(x), 28 _(y), 28 _(z) and other ones of these packs, it may beuseful to use four, five, six or even more location receivers, whenpossible, to determine the location of a given pack. For example, insome embodiment, a location algorithm implemented by the locationdetermination unit 432 may: determine which location receivers 303, 43,143, 243 are at known locations, i.e., the “located” location receivers;list all the location transmitters 41, 141, 241 of the packs 22 ₁ . . .22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P) that can be seen by five,four or three of the located location receivers; compute the locationsof those packs that can be seen by the maximum number of locatedlocation receivers first, which, in this example, is assumed to be five(in other examples, this may be different depending on the number oflocation receivers at known locations); and once the locations of thosepacks is established, their location receivers are turned on, themselvesbecoming “located” location receivers, and their measurements added tothe location computation capability. This is then repeated forming a newlist of unlocated location transmitters 41, 141, 241 of the packs 22 ₁ .. . 22 _(N), 26 ₁ . . . 26 _(R) 24 ₁ . . . 24 _(P) that can be seen byfive, four or three located location receivers and calculating thelocation of those unlocated location transmitters which can be seen bythe maximum number of located location receivers. In cases where lessthan five located location receivers can see an unlocated locationtransmitter, the process can be continued at a level of four locatedlocation receivers, still allowing the determination of the location ofthe unlocated location transmitter in 3D, or even with three locatedlocation receivers, although this can allow location in 2D. Startingwith five (or more) located location receivers rather than just four orthree, may help to counter errors which may otherwise be introduced dueto various factors, such as a non-deterministic propagation pathassociated with the wireless location technology used. For instance,using five located location receivers enables five different 3Dcomputations (Rx_(1,2,3,4), Rx_(1,2,3,5), Rx_(1,2,4,5), Rx_(1,3,4,5) andRx_(2,3,4,5)) or ten different 2D computations (Rx_(1,2,3), Rx_(1,2,4),Rx_(1,2,5), Rx_(1,3,4), Rx_(1,3,5), Rx_(1,4,5), Rx_(2,3,4), Rx_(2,3,5),Rx_(2,4,5) and Rx_(3,4,5)) to be carried out, allowing detection ofpotential “outlier” results due to impairments on one path or in onereceiver to be detected, whereas using four located location receiversallows a single 3D computation or up to four 2D computations.

With the first responders 14 ₁ . . . 14 _(N) and the patients 18 ₁ . . .18 _(P) being mobile, in some cases running or otherwise moving veryrapidly, the location determination unit 432 implemented by theenvironmental data processing engine 411 of the ECAS 30 may employfast-tracking interpolative algorithms to keep track of the locations ofthe first responder packs 22 ₁ . . . 22 _(N) and the patient packs 24 ₁. . . 24 _(P). For example, if a first responder 14; is moving at 8 feetper second (˜5 mph), successive location readings on a 250 msecresolution will place him 2 feet from his/her previous location. If 2feet is larger than an acceptable error for the system, and if his/herfirst responder pack 22 _(i) is being used to locate other packs, it maybe necessary to reduce effects of this error. For instance, if awireless location signal from a remote pack is received at 102.453 msafter the last wireless location signal transmitted by the pack 22 _(i),then at 8 feet per second the first responder 14 _(i) will have covered0.811624 ft and so the location computation can take into account thatoffset.

Although in this embodiment, location computations to determine thelocations of the packs 22 ₁ . . . 22 _(N), 26 ₁ . . . 26 _(R), 24 ₁ . .. 24 _(P) are carried out remotely by the ECAS 30, in other embodiments,such location computations may be performed locally by one or more ofthe ECAS outstations 28 ₁ . . . 28 _(M). For example, in someembodiments, each of the ECAS outstations 28 ₁ . . . 28 _(M) may effectlocation computations to determine the locations of those packs that arelocated inside its primary coverage area A1 and/or that are located in aregion where its secondary coverage area A2 or tertiary coverage area A3overlaps with the coverage area P of one or more packs from which itreceives wireless signals. The ECAS outstations 28 ₁ . . . 28 _(M) maythen collaborate to exchange the locations of the packs that they haveindividually determined and to determine the locations of those packsthat are located in regions where their secondary and tertiary coverageareas A2, A3 overlap. In other embodiments, one of the ECAS outstations28 ₁ . . . 28 _(M) may be a “master” outstation to which other ones ofthese outstations (i.e., “slave” outstations) transmit data derived fromwireless signals they receive from packs in order to allow the masteroutstation to effect the location computations. Location data indicativeof the locations of the packs may then be transmitted by each of theECAS outstations 28 ₁ . . . 28 _(M) or the master outstation, as thecase may be, to the ECAS 30.

More generally, while in embodiments considered above the processingsystem 20 is distributed between locations that are remote from oneanother (i.e., distributed between the ECAS outstations 28 ₁ . . . 28_(M) at the incident scene 12 and the ECAS 30 located remotely from theincident scene 12), in other embodiments, the processing system 20 mayreside entirely in a single location (i.e., its functionality may beimplemented entirely by one of the ECAS outstations 28 ₁ . . . 28 _(M)or the ECAS 30).

Those skilled in the art will appreciate that, in some embodiments,certain functionality of a given component described herein (e.g., theprocessing entity 50, 150, 250, 360 or 420) may be implemented aspre-programmed hardware or firmware elements (e.g., application specificintegrated circuits (ASICs), electrically erasable programmableread-only memories (EEPROMs), etc.) or other related elements. In otherembodiments, a given component described herein (e.g., the processingentity 50, 150, 250, 360 or 420) may comprise a general-purposeprocessor having access to a storage medium that is fixed, tangible, andreadable by the general-purpose processor and that stores program codefor operation of the general-purpose processor to implementfunctionality of that given component. The storage medium may store dataoptically (e.g., an optical disk such as a CD-ROM or a DVD),magnetically (e.g., a hard disk drive, a removable diskette),electrically (e.g., semiconductor memory, including ROM such as EPROM,EEPROM and Flash memory, or RAM), or in any another suitable way.Alternatively, the program code may be stored remotely but transmittableto the given component via a modem or other interface device connectedto a network over a transmission medium. The transmission medium may beeither a tangible medium (e.g., optical or analog communications lines)or a medium implemented using wireless techniques (e.g., RF, microwave,infrared or other wireless transmission schemes).

Although various embodiments and examples have been presented, this wasfor the purpose of describing, but not limiting, the invention. Variousmodifications and enhancements will become apparent to those of ordinaryskill in the art and are within the scope of the invention, which isdefined by the appended claims.

1. A method for locating a plurality of portable modules at an incidentscene, said method comprising: receiving first data derived from awireless signal transmitted by a first one of the portable modules andreceived by at least three receivers of a plurality of receiverstransported to the incident scene; determining a location of the firstone of the portable modules based on the first data; receiving seconddata derived from a wireless signal transmitted by a second one of theportable modules and received by the first one of the portable modules;and determining a location of the second one of the portable modulesbased on the second data and the location of the first one of theportable modules.
 2. A method as claimed in claim 1, wherein the firstdata comprises data related to times of arrival of the wireless signaltransmitted by the first one of the portable modules at the at leastthree receivers, and the second data comprises data related to a time ofarrival of the wireless signal transmitted by the second one of theportable modules at the first one of the portable modules.
 3. A methodas claimed in claim 2, wherein the wireless signal transmitted by thesecond one of the portable modules is received by at least one receiverof the plurality of receivers, and the second data comprises datarelated to a time of arrival of the wireless signal transmitted by thesecond one of the portable modules at each of the at least one receiver.4. A method as claimed in claim 2, wherein the wireless signaltransmitted by the second one of the portable modules is received by tworeceivers of the plurality of receivers, and the second data comprisesdata related to times of arrival of the wireless signal transmitted bythe second one of the portable modules at the two receivers.
 5. A methodas claimed in claim 2, comprising: receiving third data related to timesof arrival of a wireless signal transmitted by a third one of theportable modules and received by at least three entities amongst theplurality of receivers and the plurality of portable modules; anddetermining a location of the third one of the portable modules based onthe third data; wherein the wireless signal transmitted by the secondone of the portable modules is received by one receiver of the pluralityof receivers and by the third one of the portable modules, the seconddata comprises data related to times of arrival of the wireless signaltransmitted by the second one of the portable modules at the onereceiver and the third one of the portable modules, and said determiningthe location of the second one of the portable modules comprisesdetermining the location of the second one of the portable modules basedon the second data, the location of the first one of the portablemodules and the location of the third one of the portable modules.
 6. Amethod as claimed in claim 1, comprising: receiving third data derivedfrom a wireless signal transmitted by a third one of the portablemodules and received by the second one of the portable modules; anddetermining a location of the third one of the portable modules based onthe third data and the location of the second one of the portablemodules.
 7. A method as claimed in claim 6, wherein the first datacomprises data related to times of arrival of the wireless signaltransmitted by the first one of the portable modules at the at leastthree receivers, the second data comprises data related to a time ofarrival of the wireless signal transmitted by the second one of theportable modules at the first one of the portable modules, and the thirddata comprises data related to a time of arrival of the wireless signaltransmitted by the third one of the portable modules at the second oneof the portable modules.
 8. A method as claimed in claim 1, wherein theplurality of receivers are mounted to at least one vehicle transportedto the incident scene.
 9. A method as claimed in claim 8, wherein the atleast one vehicle comprises a plurality of vehicles and the at leastthree receivers are distributed amongst at least two of the vehicles.10. A method as claimed in claim 8, wherein at least some of theplurality of receivers are disposed on a plurality of extensible armsthat are capable of being extended relative to a body of each vehicle.11. A method as claimed in claim 1, wherein the location of the firstone of the portable modules and the location of the second one of theportable modules are determined with a precision of 1 m or better.
 12. Amethod as claimed in claim 1, wherein the wireless signal transmitted bythe first one of the portable modules is transmitted by a UWBtransmitter of the first one of the portable modules, and the wirelesssignal transmitted by the second one of the portable modules istransmitted by a UWB transmitter of the second one of the portablemodules.
 13. A method as claimed in claim 1, wherein the plurality ofportable modules comprises at least one portable first responder moduleto be carried by at least one first responder at the incident scene andat least one portable patient module to be associated with at least onepatient at the incident scene.
 14. A method as claimed in claim 12,wherein the plurality of portable modules comprises at least oneportable drop module to be placed at least one fixed location at theincident scene by the at least one first responder.
 15. A method asclaimed in claim 2, wherein the time of arrival of the wireless signaltransmitted by the second one of the portable modules at the first oneof the portable modules is measured relative to a time of transmissionof the wireless signal transmitted by the first one of the portablemodules.
 16. A system for locating a plurality of portable modules at anincident scene, said system comprising: a plurality of receiverstransportable to the incident scene; and a processing entity configuredto: determine a location of a first one of the portable modules based onfirst data derived from a wireless signal transmitted by the first oneof the portable modules and received by at least three receivers of theplurality of receivers; and determine a location of a second one of theportable modules based on the location of the first one of the portablemodules and second data derived from a wireless signal transmitted bythe second one of the portable modules and received by the first one ofthe portable modules.
 17. A system as claimed in claim 1, wherein thefirst data comprises data related to times of arrival of the wirelesssignal transmitted by the first one of the portable modules at the atleast three receivers, and the second data comprises data related to atime of arrival of the wireless signal transmitted by the second one ofthe portable modules at the first one of the portable modules.
 18. Asystem as claimed in claim 17, wherein the wireless signal transmittedby the second one of the portable modules is received by at least onereceiver of the plurality of receivers, and the second data comprisesdata related to a time of arrival of the wireless signal transmitted bythe second one of the portable modules at each of the at least onereceiver.
 19. A system as claimed in claim 17, wherein the wirelesssignal transmitted by the second one of the portable modules is receivedby two receivers of the plurality of receivers, and the second datacomprises data related to times of arrival of the wireless signaltransmitted by the second one of the portable modules at the tworeceivers.
 20. A system as claimed in claim 17, wherein processingentity is configured to: determine a location of a third one of theportable modules based on third data related to times of arrival of awireless signal transmitted by the third one of the portable modules andreceived by at least three entities amongst the plurality of receiversand the plurality of portable modules; wherein the wireless signaltransmitted by the second one of the portable modules is received by onereceiver of the plurality of receivers and by the third one of theportable modules, the second data comprises data related to times ofarrival of the wireless signal transmitted by the second one of theportable modules at the one receiver and the third one of the portablemodules, and, to determine the location of the second one of theportable modules, said processing entity is configured to determine thelocation of the second one of the portable modules based on the seconddata, the location of the first one of the portable modules and thelocation of the third one of the portable modules.
 21. A system asclaimed in claim 16, wherein processing entity is configured todetermine a location of a third one of the portable modules based on thelocation of the second one of the portable modules and third dataderived from a wireless signal transmitted by the third one of theportable modules and received by the second one of the portable modules.22. A system as claimed in claim 21, wherein the first data comprisesdata related to times of arrival of the wireless signal transmitted bythe first one of the portable modules at the at least three receivers,the second data comprises data related to a time of arrival of thewireless signal transmitted by the second one of the portable modules atthe first one of the portable modules, and the third data comprises datarelated to a time of arrival of the wireless signal transmitted by thethird one of the portable modules at the second one of the portablemodules.
 23. A system as claimed in claim 16, wherein said plurality ofreceivers are mounted to at least one vehicle transported to theincident scene.
 24. A system as claimed in claim 23, wherein the atleast one vehicle comprises a plurality of vehicles and the at leastthree receivers are distributed amongst at least two of the vehicles.25. A system as claimed in claim 23, wherein at least some of saidplurality of receivers are disposed on a plurality of extensible armsthat are capable of being extended relative to a body of each vehicle.26. A system as claimed in claim 16, wherein the location of the firstone of the portable modules and the location of the second one of theportable modules are determined with a precision of 1 m or better.
 27. Asystem as claimed in claim 1, wherein the wireless signal transmitted bythe first one of the portable modules is transmitted by a UWBtransmitter of the first one of the portable modules, and the wirelesssignal transmitted by the second one of the portable modules istransmitted by a UWB transmitter of the second one of the portablemodules.
 28. A system as claimed in claim 16, wherein the plurality ofportable modules comprises at least one portable first responder moduleto be carried by at least one first responder at the incident scene andat least one portable patient module to be associated with at least onepatient at the incident scene.
 29. A system as claimed in claim 28,wherein the plurality of portable modules comprises at least oneportable drop module to be placed at least one fixed location at theincident scene by the at least one first responder. 30.Computer-readable media containing computer-readable program codeexecutable by a computing apparatus to implement a process for locatinga plurality of portable modules at an incident scene, saidcomputer-readable program code comprising: first program code forcausing the computing apparatus to be attentive to receipt of first dataderived from a wireless signal transmitted by a first one of theportable modules and received by at least three receivers of a pluralityof receivers transported to the incident scene; second program code forcausing the computing apparatus to determine a location of the first oneof the portable modules based on the first data; third program code forcausing the computing apparatus to be attentive to receipt of seconddata derived from a wireless signal transmitted by a second one of theportable modules and received by the first one of the portable modules;and fourth program code for causing the computing apparatus to determinea location of the second one of the portable modules based on the seconddata and the location of the first one of the portable modules.